MEDICARE: GREGG MICHAEL ANIGIAN 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	2086S0122X	Plastic and Reconstructive Surgery Physician	H7116	TX

General Provider Information

NPI Number	:	1538169966
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	GREGG MICHAEL ANIGIAN MD

Provider Business Mailing Address
First Line	:	8220 WALNUT HILL LN
Second Line	:	SUITE 108
City	:	DALLAS
State	:	TX
Zip	:	75231-4427
Country	:	US
Telephone Number	:	214-369-0006
Fax Number	:	214-369-0190

Provider Business Practice Location Address
First Line	:	8220 WALNUT HILL LN
Second Line	:	SUITE 108
City	:	DALLAS
State	:	TX
Zip	:	75231-4427
Country	:	US
Telephone Number	:	214-369-0006
Fax Number	:	214-369-0190

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

Provider Enumeration Date	:	07/28/2005
Last Update Date	:	01/04/2011

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