Basic Information
| Provider Information | |||||||||
| NPI: | 1619445210 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | BHANDARI | ||||||||
| FirstName: | PRATIVA | ||||||||
| MiddleName: | N | ||||||||
| NamePrefix: | MS. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 29206 GRAND GORGE DR | ||||||||
| Address2: | |||||||||
| City: | KATY | ||||||||
| State: | TX | ||||||||
| PostalCode: | 774945285 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8432249094 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 7629 TIKI DR | ||||||||
| Address2: | |||||||||
| City: | FULSHEAR | ||||||||
| State: | TX | ||||||||
| PostalCode: | 774411548 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2813460913 | ||||||||
| FaxNumber: | 2813460913 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 11/13/2018 | ||||||||
| LastUpdateDate: | 08/12/2022 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 08/12/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363LF0000X | AP138705 | TX | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Family |
No ID Information.