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NPI Code Detail

MEDICARE: DR. JIM ANAGNOSTIS M.D.

MEDICARE: DR. JIM ANAGNOSTIS 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
1207Q00000XFamily Medicine PhysicianE2437TX

General Provider Information

NPI Number : 1144281205
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. JIM ANAGNOSTIS M.D.
Provider Business Mailing Address
First Line : 1300 S FIELDER RD
Second Line :
City : ARLINGTON
State : TX
Zip : 76013-2348
Country : US
Telephone Number : 817-277-2221
Fax Number :
Provider Business Practice Location Address
First Line : 1300 S FIELDER RD
Second Line :
City : ARLINGTON
State : TX
Zip : 76013-2348
Country : US
Telephone Number : 817-277-2221
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/29/2006
Last Update Date : 02/16/2011

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