Organization
BHARAT B LATTHE MD PA
Active
Parent organization
FAMILY & SENIOR MEDICAL CLINIC PA
Other names
Family & Senior Medical Clinic PA
Organization subpart
Yes
Provider details
NPI number
Legal business name
FAMILY & SENIOR MEDICAL CLINIC PA
Authorized official
BHARAT LATTHE MD (OWNER)
(281) 709-2555
Entity
Organization
Contact information
Practice address
150 PINE FOREST DR, SUITE 110, SHENANDOAH, TX 77384-5302
(281) 709-2555
(281) 440-9915
Mailing address
150 PINE FOREST DR, SUITE 110, SHENANDOAH, TX 77384-5302
(281) 709-2555
(281) 440-9915
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
K6082
TX
207QG0300X
Geriatric Medicine (Family Medicine) Physician
K6082
TX
363L00000X
Nurse Practitioner
651038
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00064ET
BLUE CROSS
TX
05
—
120662506
—
TX
05
—
152611303
—
TX
05
—
187619501
—
TX
01
—
187619502
TEXAS HEALTH STEPS
TX
01
—
P000614
MEDICARE RAILROAD
—
Enumeration date
05/16/2006
Last updated
03/04/2024
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