Provider Demographics
NPI:1821668310
Name:TAYAL, BHUPENDAR
Entity Type:Individual
Prefix:
First Name:BHUPENDAR
Middle Name:
Last Name:TAYAL
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1910 LACYWOOD APT 3
Mailing Address - Street 2:
Mailing Address - City:EDINBURG
Mailing Address - State:TX
Mailing Address - Zip Code:78539-2458
Mailing Address - Country:US
Mailing Address - Phone:956-877-8869
Mailing Address - Fax:
Practice Address - Street 1:6565 FANNIN STREET
Practice Address - Street 2:HOUSTON METHODIST HOSPITAL
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77030
Practice Address - Country:US
Practice Address - Phone:346-238-5038
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-06-28
Last Update Date:2021-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXBP10077094207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease