Provider Demographics
NPI:1730127770
Name:BAVARE, ARUSHA A (MD)
Entity Type:Individual
Prefix:DR
First Name:ARUSHA
Middle Name:A
Last Name:BAVARE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:16605 SOUTHWEST FWY
Mailing Address - Street 2:STE 175
Mailing Address - City:SUGAR LAND
Mailing Address - State:TX
Mailing Address - Zip Code:77479-0003
Mailing Address - Country:US
Mailing Address - Phone:281-565-1112
Mailing Address - Fax:281-565-1102
Practice Address - Street 1:16605 SOUTHWEST FWY
Practice Address - Street 2:SUITE 175
Practice Address - City:SUGAR LAND
Practice Address - State:TX
Practice Address - Zip Code:77479-0003
Practice Address - Country:US
Practice Address - Phone:281-565-1112
Practice Address - Fax:281-565-1102
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-03
Last Update Date:2020-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXL7979207RG0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0300XAllopathic & Osteopathic PhysiciansInternal MedicineGeriatric Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX164649902OtherMEDICAID
TX8CW373OtherBCBS
TXP00959950OtherMCR RR
TXTXB125922OtherMEDICARE
TX1646499010OtherMEDICAID
TXP00082071OtherMEDICARE RR
TX7215322OtherCIGNA
TX9961061OtherAETNA
TX164649901Medicaid
TX8B3752OtherMEDICARE
TX2498615OtherUNITED HC
TX8P6216OtherBCBS
TX164649901Medicaid