Healthcare Provider Details

I. General information

NPI: 1104051382
Provider Name (Legal Business Name): ANEESH GEORGE M.D
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/18/2009
Last Update Date: 06/10/2022
Certification Date: 06/10/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1901 VETERANS MEMORIAL DR
TEMPLE TX
76504-7451
US

IV. Provider business mailing address

1901 VETERANS MEMORIAL DR
TEMPLE TX
76504-7451
US

V. Phone/Fax

Practice location:
  • Phone: 512-324-4083
  • Fax:
Mailing address:
  • Phone: 254-743-2575
  • Fax: 254-743-0114

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberBPI 0035392
License Number StateTX
# 2
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberP2447
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: