Organization Active NPI

Raj K Bhalla MD PA

  • Cardiovascular Disease Physician
  • Houston, TX
National Provider Identifier
1104906825
Registry record updated Jan 21, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
Legal business name
RAJ K BHALLA MD PA
Practice address
2020 Nasa Pkwy
Suite 210
Houston, TX 77058-3683
Phone
(281) 333-9200
Fax
(281) 333-3570
NPI assigned
Oct 17, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 21, 2016

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Susan Polidori
Title
Office Manager
Phone
(281) 333-9200

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207RC0000X Primary

Addresses

Primary practice location

2020 Nasa Pkwy
Suite 210
Houston, TX 77058-3683

Mailing address

2020 Nasa Pkwy
Suite 210
Houston, TX 77058-3683
Phone (281) 333-9200

Other identifiers 1

IdentifierTypeStateIssuer
079588201MedicaidTX

Other names 1

  • COMPREHENSIVE CARDIOLOGY Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20061018000490 TX Part B Supplier - Clinic/Group Practice 3476559238 Receives reassigned benefits from 5 practitioners
Practice locations: Houston, TX; Friendswood, TX

National Provider Directory

National Provider Directory

Locations

107 Woodlawn Dr
Friendswood, TX 77546
Phone (832) 783-1079

2200 Nasa Pkwy
#One
Houston, TX 77058
Phone (281) 333-9200

2020 Nasa Pkwy
Ste 210
Houston, TX 77058
Phone (281) 333-9200

2200 Nasa Pkwy
Ste 220
Houston, TX 77058
Phone (281) 333-9200

Practitioners & affiliated clinicians

Practitioners 8

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1161043200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1453334400000",
    "number": "1104906825",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2020 NASA PKWY",
            "address_2": "SUITE 210",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770583683",
            "telephone_number": "281-333-9200",
            "fax_number": "281-333-3570"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2020 NASA PKWY",
            "address_2": "SUITE 210",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770583683",
            "telephone_number": "281-333-9200",
            "fax_number": "281-333-3570"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RAJ K BHALLA MD PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-17",
        "last_updated": "2016-01-21",
        "status": "A",
        "authorized_official_last_name": "POLIDORI",
        "authorized_official_first_name": "SUSAN",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "281-333-9200"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "079588201",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "COMPREHENSIVE CARDIOLOGY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Houston, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 21, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.