Provider Demographics
NPI:1982428348
Name:BHAKTA IMPLANT CENTER OF HOUSTON PLLC
Entity type:Organization
Organization Name:BHAKTA IMPLANT CENTER OF HOUSTON PLLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:BHAVESH
Authorized Official - Middle Name:B
Authorized Official - Last Name:BHAKTA
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:512-825-9921
Mailing Address - Street 1:105 AZIMUTH DR
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78717-4953
Mailing Address - Country:US
Mailing Address - Phone:512-825-9921
Mailing Address - Fax:
Practice Address - Street 1:3211 W GRAND PKWY N STE 600
Practice Address - Street 2:
Practice Address - City:KATY
Practice Address - State:TX
Practice Address - Zip Code:77449-6925
Practice Address - Country:US
Practice Address - Phone:512-825-9921
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-11-12
Last Update Date:2025-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QM1300XAmbulatory Health Care FacilitiesClinic/CenterMulti-Specialty
No1223S0112XDental ProvidersDentistOral and Maxillofacial SurgeryGroup - Multi-Specialty