MEDICARE: SYED IMTIAZ ANWAR M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207R00000X	Internal Medicine Physician	K3671	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1053314401
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SYED IMTIAZ ANWAR M.D.

Provider Business Mailing Address
First Line	:	2929 CALDER ST
Second Line	:	SUITE 100
City	:	BEAUMONT
State	:	TX
Zip	:	77702-1845
Country	:	US
Telephone Number	:	409-833-9797
Fax Number	:	409-839-3174

Provider Business Practice Location Address
First Line	:	3570 COLLEGE ST
Second Line	:	SUITE 200
City	:	BEAUMONT
State	:	TX
Zip	:	77701-4683
Country	:	US
Telephone Number	:	409-833-9797
Fax Number	:	409-654-6803

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/31/2005
Last Update Date	:	09/11/2018

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