Provider Demographics
NPI:1629890819
Name:BHANDARI, DEEPAK (PHD)
Entity type:Individual
Prefix:DR
First Name:DEEPAK
Middle Name:
Last Name:BHANDARI
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5686 PRINCETON RUN TRL
Mailing Address - Street 2:
Mailing Address - City:TUCKER
Mailing Address - State:GA
Mailing Address - Zip Code:30084-8465
Mailing Address - Country:US
Mailing Address - Phone:865-773-8205
Mailing Address - Fax:
Practice Address - Street 1:1400 N SAM HOUSTON PKWY E STE 158
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77032-2959
Practice Address - Country:US
Practice Address - Phone:832-770-4686
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-10-29
Last Update Date:2024-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory