Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207L00000X | Anesthesiologist | L9101 | TX |
NPI | 1003954157 |
---|---|
Provider Name | Dr. Shreyas P Bhavsar |
First Address | Houston, TX 77210-4439 |
Second Address | Houston, TX 77030-4000 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 01/02/2007 |
Last Update Date | 02/12/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
175260203 | (05) | TX |
175260204 | (05) | TX |
175260205 | MEDICAID CSHCN (01) | TX |
1818216 | (05) | LA |
8CB681 | BLUE CROSS BLUE SHIELD (01) | TX |
8CH239 | BCBS (01) | TX |