Provider Demographics
NPI:1932187853
Name:BHARDWAJ, NEETA R (MD)
Entity Type:Individual
Prefix:
First Name:NEETA
Middle Name:R
Last Name:BHARDWAJ
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11710 FM 1960 RD W
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77065-3514
Mailing Address - Country:US
Mailing Address - Phone:281-469-6097
Mailing Address - Fax:281-469-9617
Practice Address - Street 1:11710 FM 1960 RD W
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77065-3514
Practice Address - Country:US
Practice Address - Phone:281-469-6097
Practice Address - Fax:281-469-9617
Is Sole Proprietor?:Yes
Enumeration Date:2006-01-03
Last Update Date:2011-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXH2991208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX10575729OtherCAQH
TX128252701Medicaid
TX128252701Medicaid