Provider Demographics
NPI:1205124856
Name:RAJBHANDARI, PUKAR BAHADUR (DDS)
Entity type:Individual
Prefix:DR
First Name:PUKAR
Middle Name:BAHADUR
Last Name:RAJBHANDARI
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4103 CHARBRAY CT
Mailing Address - Street 2:
Mailing Address - City:CEDAR PARK
Mailing Address - State:TX
Mailing Address - Zip Code:78613-7744
Mailing Address - Country:US
Mailing Address - Phone:402-321-9054
Mailing Address - Fax:
Practice Address - Street 1:6421 W 43RD ST
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77092-4005
Practice Address - Country:US
Practice Address - Phone:832-941-4010
Practice Address - Fax:832-941-4011
Is Sole Proprietor?:No
Enumeration Date:2011-07-18
Last Update Date:2013-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX272131223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice