Provider Demographics
NPI:1588744999
Name:MUTHUSWAMY, BHUVANA (MD)
Entity type:Individual
Prefix:
First Name:BHUVANA
Middle Name:
Last Name:MUTHUSWAMY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4710 BELLAIRE BLVD
Mailing Address - Street 2:
Mailing Address - City:BELLAIRE
Mailing Address - State:TX
Mailing Address - Zip Code:77401-4526
Mailing Address - Country:US
Mailing Address - Phone:713-441-9040
Mailing Address - Fax:
Practice Address - Street 1:4710 BELLAIRE BLVD
Practice Address - Street 2:
Practice Address - City:BELLAIRE
Practice Address - State:TX
Practice Address - Zip Code:77401-4526
Practice Address - Country:US
Practice Address - Phone:713-441-9040
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-17
Last Update Date:2016-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXK8365207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX145379703Medicaid
TX145379710Medicaid
TXP01170503OtherRR MEDICARE
TX8DP011OtherBLUE CROSS BLUE SHIELD
TX145379709Medicaid
TX8G0568Medicare PIN
TX269237YKWUMedicare PIN
TXP00692238Medicare PIN
TX8L14351Medicare PIN
TXP01170503OtherRR MEDICARE
TX145379709Medicaid
TX269237ZSWDMedicare PIN