Provider Demographics
NPI:1861454217
Name:BHALLA, RAJINDER K (MD)
Entity Type:Individual
Prefix:
First Name:RAJINDER
Middle Name:K
Last Name:BHALLA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:RAJ
Other - Middle Name:K
Other - Last Name:BHALLA
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:2020 NASA PKWY # 1
Mailing Address - Street 2:STE 210
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77058-3683
Mailing Address - Country:US
Mailing Address - Phone:281-333-9200
Mailing Address - Fax:281-333-3570
Practice Address - Street 1:2020 NASA PKWY # 1
Practice Address - Street 2:STE 210
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77058-3683
Practice Address - Country:US
Practice Address - Phone:281-333-9200
Practice Address - Fax:281-333-3570
Is Sole Proprietor?:No
Enumeration Date:2006-04-03
Last Update Date:2012-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXF8409207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX0122601102Medicaid
TX81570JMedicare PIN
TX0122601102Medicaid