Healthcare Provider Details

I. General information

NPI: 1548452675
Provider Name (Legal Business Name): ANITA GREWAL HOLTZ MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/13/2007
Last Update Date: 03/07/2023
Certification Date: 02/10/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6124 W PARKER RD STE 530
PLANO TX
75093-8140
US

IV. Provider business mailing address

6124 W PARKER RD STE 530
PLANO TX
75093-8140
US

V. Phone/Fax

Practice location:
  • Phone: 214-778-1075
  • Fax: 214-778-1237
Mailing address:
  • Phone: 214-778-1075
  • Fax: 214-778-1237

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number125051595
License Number StateIL
# 2
Primary TaxonomyN
Taxonomy Code207RP1001X
TaxonomyPulmonary Disease Physician
License NumberN6361
License Number StateTX
# 3
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License NumberN6361
License Number StateTX
# 4
Primary TaxonomyY
Taxonomy Code207RC0200X
TaxonomyCritical Care Medicine (Internal Medicine) Physician
License NumberN6361
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: