Provider Demographics
NPI:1003800186
Name:HUSSAIN, ANEELA N (MD)
Entity Type:Individual
Prefix:DR
First Name:ANEELA
Middle Name:N
Last Name:HUSSAIN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:312 TULOROSA RDG
Mailing Address - Street 2:
Mailing Address - City:HELOTES
Mailing Address - State:TX
Mailing Address - Zip Code:78023-4508
Mailing Address - Country:US
Mailing Address - Phone:210-629-9972
Mailing Address - Fax:
Practice Address - Street 1:4610 E SOUTHCROSS BLVD
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78222-4914
Practice Address - Country:US
Practice Address - Phone:210-648-1491
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2005-09-06
Last Update Date:2021-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY219605-1207Q00000X
TXT0810207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02232608Medicaid
NYH29655Medicare UPIN
NY02232608Medicaid