Provider Demographics
NPI:1013085174
Name:PANCHOLY, APURVA (MD)
Entity Type:Individual
Prefix:
First Name:APURVA
Middle Name:
Last Name:PANCHOLY
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 1:915 GESSNER RD STE 400
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77024-2667
Mailing Address - Country:US
Mailing Address - Phone:713-486-6160
Mailing Address - Fax:713-827-7754
Practice Address - Street 1:929 GESSNER
Practice Address - Street 2:SUITE 1300
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77024
Practice Address - Country:US
Practice Address - Phone:713-456-8010
Practice Address - Fax:713-456-8153
Is Sole Proprietor?:No
Enumeration Date:2006-11-30
Last Update Date:2019-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35083921207V00000X
TXN7857207VF0040X, 207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VF0040XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyFemale Pelvic Medicine and Reconstructive Surgery
No207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXTXB117337Medicare PIN
H42361Medicare UPIN
OH2528054Medicaid
TXTXB117337Medicare PIN