Provider Demographics
NPI:1750774832
Name:DAS, BHAGVANTI
Entity type:Individual
Prefix:
First Name:BHAGVANTI
Middle Name:
Last Name:DAS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2338 MARONEAL ST
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77030-3218
Mailing Address - Country:US
Mailing Address - Phone:713-666-7984
Mailing Address - Fax:713-666-1337
Practice Address - Street 1:2338 MARONEAL ST
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77030-3218
Practice Address - Country:US
Practice Address - Phone:713-666-7984
Practice Address - Fax:713-666-1337
Is Sole Proprietor?:Yes
Enumeration Date:2015-03-12
Last Update Date:2015-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXD8874207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology