Healthcare Provider Details

I. General information

NPI: 1053291104
Provider Name (Legal Business Name): ANAGHA ELATI
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/08/2025
Last Update Date: 09/08/2025
Certification Date: 09/08/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

19138 US HIGHWAY 281 N
SAN ANTONIO TX
78258-4988
US

IV. Provider business mailing address

250 TREELINE PARK APT 406
SAN ANTONIO TX
78209-7401
US

V. Phone/Fax

Practice location:
  • Phone: 210-281-9595
  • Fax:
Mailing address:
  • Phone: 512-745-6575
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367H00000X
TaxonomyAnesthesiologist Assistant
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: