Provider Demographics
NPI:1730717927
Name:AJAY K BHORA MD PA
Entity type:Organization
Organization Name:AJAY K BHORA MD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:AJAY
Authorized Official - Middle Name:KUMAR
Authorized Official - Last Name:BHORA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:716-901-6803
Mailing Address - Street 1:5430 CLOUDS CREEK LN
Mailing Address - Street 2:
Mailing Address - City:SUGAR LAND
Mailing Address - State:TX
Mailing Address - Zip Code:77479-4933
Mailing Address - Country:US
Mailing Address - Phone:716-901-6803
Mailing Address - Fax:928-212-1869
Practice Address - Street 1:2647 CORDES DRIVE
Practice Address - Street 2:
Practice Address - City:SUGAR LAND
Practice Address - State:TX
Practice Address - Zip Code:77479
Practice Address - Country:US
Practice Address - Phone:716-901-6803
Practice Address - Fax:928-212-1869
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-04-01
Last Update Date:2020-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty