Provider Demographics
NPI:1700035961
Name:RATHI, BANSHI MOHAN (MD)
Entity Type:Individual
Prefix:DR
First Name:BANSHI
Middle Name:MOHAN
Last Name:RATHI
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 1:23814 HIGHWAY 59 N
Mailing Address - Street 2:
Mailing Address - City:KINGWOOD
Mailing Address - State:TX
Mailing Address - Zip Code:77339-1510
Mailing Address - Country:US
Mailing Address - Phone:281-312-5558
Mailing Address - Fax:281-717-6076
Practice Address - Street 1:23814 HIGHWAY 59 N
Practice Address - Street 2:
Practice Address - City:KINGWOOD
Practice Address - State:TX
Practice Address - Zip Code:77339-1510
Practice Address - Country:US
Practice Address - Phone:281-312-5558
Practice Address - Fax:281-727-0827
Is Sole Proprietor?:No
Enumeration Date:2008-09-11
Last Update Date:2020-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXQ3582207RN0300X
KY45049207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
KYK051730Medicare PIN
KY7100214220Medicaid