Provider Demographics
NPI:1053572164
Name:BHANDARI, HANUL SRINIVAS (MD)
Entity type:Individual
Prefix:DR
First Name:HANUL
Middle Name:SRINIVAS
Last Name:BHANDARI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4358 LOCKHILL SELMA RD STE 106
Mailing Address - Street 2:
Mailing Address - City:SHAVANO PARK
Mailing Address - State:TX
Mailing Address - Zip Code:78249-4167
Mailing Address - Country:US
Mailing Address - Phone:210-686-5000
Mailing Address - Fax:210-239-5060
Practice Address - Street 1:4358 LOCKHILL SELMA RD STE 106
Practice Address - Street 2:
Practice Address - City:SHAVANO PARK
Practice Address - State:TX
Practice Address - Zip Code:78249-4167
Practice Address - Country:US
Practice Address - Phone:210-686-5000
Practice Address - Fax:210-239-5060
Is Sole Proprietor?:Yes
Enumeration Date:2008-06-20
Last Update Date:2019-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXP28282084S0012X, 2084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084S0012XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologySleep Medicine
No2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX3361438Medicaid
TX327579YN9DMedicare PIN
TX013361438Medicaid