Provider Demographics
NPI:1659312015
Name:TALATI, BIMALKUMAR A (MD)
Entity Type:Individual
Prefix:
First Name:BIMALKUMAR
Middle Name:A
Last Name:TALATI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13219 DOTSON RD
Mailing Address - Street 2:STE 210
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77070-4308
Mailing Address - Country:US
Mailing Address - Phone:281-640-8352
Mailing Address - Fax:281-640-8357
Practice Address - Street 1:13219 DOTSON RD
Practice Address - Street 2:STE 210
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77070-4308
Practice Address - Country:US
Practice Address - Phone:281-640-8352
Practice Address - Fax:281-640-8357
Is Sole Proprietor?:No
Enumeration Date:2006-06-09
Last Update Date:2021-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXL8528207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX168940801Medicaid
TX169363201Medicaid
TX0A5265Medicare PIN
G64018Medicare UPIN