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NPI Code Detail

MEDICARE: DR. ANISHA VAKIL WAXALI MD

MEDICARE: DR. ANISHA VAKIL WAXALI 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
1207R00000XInternal Medicine PhysicianK2133TX

General Provider Information

NPI Number : 1790773042
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. ANISHA VAKIL WAXALI MD
Provider Business Mailing Address
First Line : 4780 SWEETWATER BLVD
Second Line : SUITE 100
City : SUGAR LAND
State : TX
Zip : 77479-3162
Country : US
Telephone Number : 281-491-0094
Fax Number : 281-491-0111
Provider Business Practice Location Address
First Line : 4780 SWEETWATER BLVD STE 100
Second Line :
City : SUGAR LAND
State : TX
Zip : 77479-3163
Country : US
Telephone Number : 281-491-0094
Fax Number : 281-491-0111
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/11/2005
Last Update Date : 08/23/2022

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