Healthcare Provider Details

I. General information

NPI: 1134246374
Provider Name (Legal Business Name): ANUNAYA AASHISH
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/23/2007
Last Update Date: 04/23/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3000 N INTERSTATE 35
DENTON TX
76201-5119
US

IV. Provider business mailing address

3000 N INTERSTATE 35
DENTON TX
76201-5119
US

V. Phone/Fax

Practice location:
  • Phone: 817-820-4906
  • Fax:
Mailing address:
  • Phone: 817-820-4906
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number57009919
License Number StateOH
# 2
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberN1505
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: