Healthcare Provider Details

I. General information

NPI: 1396009890
Provider Name (Legal Business Name): CHARENYA ANANDAN M. D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/28/2012
Last Update Date: 11/06/2020
Certification Date: 11/06/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

200 1ST ST SW MAYO 8
ROCHESTER MN
55905-0001
US

IV. Provider business mailing address

7200 CAMBRIDGE ST, BCM 609
HOUSTON TX
77030
US

V. Phone/Fax

Practice location:
  • Phone: 507-284-8953
  • Fax:
Mailing address:
  • Phone: 713-798-7990
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2084N0008X
TaxonomyNeuromuscular Medicine (Psychiatry & Neurology) Physician
License NumberS0256
License Number StateTX
# 2
Primary TaxonomyY
Taxonomy Code2084N0400X
TaxonomyNeurology Physician
License NumberS0256
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: