Provider Demographics
NPI:1457771081
Name:BHULA, JITEN JAYANTILAL (MD)
Entity Type:Individual
Prefix:
First Name:JITEN
Middle Name:JAYANTILAL
Last Name:BHULA
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 1:2421 EAGLES WAY
Mailing Address - Street 2:
Mailing Address - City:PEARLAND
Mailing Address - State:TX
Mailing Address - Zip Code:77581-5176
Mailing Address - Country:US
Mailing Address - Phone:832-715-5932
Mailing Address - Fax:
Practice Address - Street 1:2421 EAGLES WAY
Practice Address - Street 2:
Practice Address - City:PEARLAND
Practice Address - State:TX
Practice Address - Zip Code:77581-5176
Practice Address - Country:US
Practice Address - Phone:832-715-5932
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-04-22
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXR2287207Q00000X
TX583823390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program