Healthcare Provider Details

I. General information

NPI: 1396447314
Provider Name (Legal Business Name): AANIE ANJANA SHAH PHILLIPS MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/21/2023
Last Update Date: 07/20/2026
Certification Date: 07/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

ONE BAYLOR PLAZA, BCM 320
HOUSTON TX
77030
US

IV. Provider business mailing address

ONE BAYLOR PLAZA, BCM 320
HOUSTON TX
77030
US

V. Phone/Fax

Practice location:
  • Phone: 832-824-1170
  • Fax: 832-825-6497
Mailing address:
  • Phone: 832-824-1170
  • Fax: 832-825-6497

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberW5509
License Number StateTX
# 2
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: