Provider Demographics
NPI:1538184023
Name:BHORA, AJAY K (MD)
Entity type:Individual
Prefix:
First Name:AJAY
Middle Name:K
Last Name:BHORA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:MILAPCHAND
Other - Middle Name:A
Other - Last Name:BHORA
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:2647 CORDES DR
Mailing Address - Street 2:
Mailing Address - City:SUGAR LAND
Mailing Address - State:TX
Mailing Address - Zip Code:77479-1353
Mailing Address - Country:US
Mailing Address - Phone:281-721-4385
Mailing Address - Fax:281-721-4386
Practice Address - Street 1:2647 CORDES DR
Practice Address - Street 2:
Practice Address - City:SUGAR LAND
Practice Address - State:TX
Practice Address - Zip Code:77479-1353
Practice Address - Country:US
Practice Address - Phone:281-721-4385
Practice Address - Fax:281-721-4386
Is Sole Proprietor?:No
Enumeration Date:2006-07-13
Last Update Date:2022-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ND10253207R00000X, 208M00000X
TXN1553207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No208M00000XAllopathic & Osteopathic PhysiciansHospitalist
Provider Identifiers
StateIdentifier IDID TypeIssuer
ND13817Medicaid
ND13817Medicaid
MN110013517Medicare PIN
NDN712076Medicare PIN