Provider Demographics
NPI:1215972211
Name:KULKARNI, PRATIBHA RAJENDRA (MD)
Entity type:Individual
Prefix:DR
First Name:PRATIBHA
Middle Name:RAJENDRA
Last Name:KULKARNI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:MISS
Other - First Name:PRATIBHA
Other - Middle Name:
Other - Last Name:GADGIL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:11511 SHADOW CREEK PKWY
Mailing Address - Street 2:
Mailing Address - City:PEARLAND
Mailing Address - State:TX
Mailing Address - Zip Code:77584-7298
Mailing Address - Country:US
Mailing Address - Phone:713-442-0000
Mailing Address - Fax:
Practice Address - Street 1:902 FROSTWOOD DR
Practice Address - Street 2:SUITE 293
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77024-2420
Practice Address - Country:US
Practice Address - Phone:713-467-5200
Practice Address - Fax:713-467-5201
Is Sole Proprietor?:No
Enumeration Date:2006-06-17
Last Update Date:2021-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXJ2142207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX129647707Medicaid
TX129647709Medicaid
TX129647708Medicaid