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NPI Code Detail

MEDICARE: DR. ANAMIKA GOENKA MD

MEDICARE: DR. ANAMIKA GOENKA MD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207R00000XInternal Medicine PhysicianMD429570PA
2208M00000XHospitalist PhysicianQ9163TX

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1003977414
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. ANAMIKA GOENKA MD
Provider Business Mailing Address
First Line : PO BOX 845347
Second Line :
City : DALLAS
State : TX
Zip : 75284-7208
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 12400 DALLAS PKWY
Second Line :
City : FRISCO
State : TX
Zip : 75033-4224
Country : US
Telephone Number : 469-495-2540
Fax Number : 215-453-4991
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/12/2006
Last Update Date : 12/31/2021

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