Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207RS0012X | Sleep Medicine | M3388 | TX |
Y | 2084N0400X | Neurologist | M3388 | TX |
NPI | 1043252448 |
---|---|
Provider Name | Dr. Amita Shimpi Bhalla |
First Address | Pasadena, TX 77505-3143 |
Second Address | Pasadena, TX 77505-3143 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 11/06/2006 |
Last Update Date | 10/08/2015 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
I52117 | (02) | TX |