Provider Demographics
NPI:1972501047
Name:BHAT, SUPRABHA (MD)
Entity Type:Individual
Prefix:DR
First Name:SUPRABHA
Middle Name:
Last Name:BHAT
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Gender:F
Credentials:MD
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Mailing Address - Street 1:7500 BEECHNUT ST
Mailing Address - Street 2:STE 266
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77074-4311
Mailing Address - Country:US
Mailing Address - Phone:713-774-0800
Mailing Address - Fax:713-774-0811
Practice Address - Street 1:7500 BEECHNUT ST
Practice Address - Street 2:SUITE 266
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77074-4335
Practice Address - Country:US
Practice Address - Phone:713-774-0800
Practice Address - Fax:713-774-0811
Is Sole Proprietor?:No
Enumeration Date:2005-07-12
Last Update Date:2019-07-22
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
TXK87142084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX042944103Medicaid
H12640Medicare UPIN