Individual
MRS. ANJULY BANSAL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
1515 HOLCOMBE BLVD, HOUSTON, TX 77030-4009
(713) 792-6161
Mailing address
P O BOX 4439, HOUSTON, TX 77210-4439
(713) 792-2991
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA05767
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200357601
—
TX
01
—
8Y8811
BCBS
TX
01
—
P00774907
RR MEDICARE
TX
Enumeration date
09/24/2008
Last updated
07/13/2011
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