Basic Information
| Provider Information | |||||||||
| NPI: | 1508489618 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | BHAKTA | ||||||||
| FirstName: | POOJA | ||||||||
| MiddleName: | N. | ||||||||
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| Mailing Information | |||||||||
| Address1: | DEPARTMENT OF INTERNAL MEDICINE 301 UNIVERSITY BLVD | ||||||||
| Address2: | |||||||||
| City: | GALVESTON | ||||||||
| State: | TX | ||||||||
| PostalCode: | 775550001 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4097722653 | ||||||||
| FaxNumber: | 4097725462 | ||||||||
| Practice Location | |||||||||
| Address1: | DEPARTMENT OF INTERNAL MEDICINE 301 UNIVERSITY BLVD | ||||||||
| Address2: | |||||||||
| City: | GALVESTON | ||||||||
| State: | TX | ||||||||
| PostalCode: | 775550001 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4097722653 | ||||||||
| FaxNumber: | 4097725462 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/22/2020 | ||||||||
| LastUpdateDate: | 05/22/2020 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 05/22/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207R00000X | BP10071292 | TX | Y | Allopathic & Osteopathic Physicians | Internal Medicine |
No ID Information.