MEDICARE: ANEES JAVED OMAR MD

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	M3051	TX

General Provider Information

NPI Number	:	1538116736
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ANEES JAVED OMAR MD

Provider Business Mailing Address
First Line	:	12221 MERIT DR
Second Line	:	STE 460
City	:	DALLAS
State	:	TX
Zip	:	75251-2202
Country	:	US
Telephone Number	:	469-374-3850
Fax Number	:	469-374-3851

Provider Business Practice Location Address
First Line	:	12221 MERIT DR
Second Line	:	STE 460
City	:	DALLAS
State	:	TX
Zip	:	75251-2202
Country	:	US
Telephone Number	:	469-374-3850
Fax Number	:	469-374-3851

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

Provider Enumeration Date	:	05/31/2006
Last Update Date	:	07/08/2007

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