Provider Demographics
NPI:1144343096
Name:MITTAL, BHARAT (DO)
Entity type:Individual
Prefix:DR
First Name:BHARAT
Middle Name:
Last Name:MITTAL
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13630 KLUGE CORNER LN
Mailing Address - Street 2:
Mailing Address - City:CYPRESS
Mailing Address - State:TX
Mailing Address - Zip Code:77429-5955
Mailing Address - Country:US
Mailing Address - Phone:832-489-9314
Mailing Address - Fax:888-366-3395
Practice Address - Street 1:2158 NORTHPARK DR
Practice Address - Street 2:
Practice Address - City:KINGWOOD
Practice Address - State:TX
Practice Address - Zip Code:77339-1745
Practice Address - Country:US
Practice Address - Phone:281-358-9020
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-04-07
Last Update Date:2024-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK4487207Q00000X
TXP7313207Q00000X, 207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine