Provider Demographics
NPI:1073544813
Name:ANIL A. DARA M.D. P.A.
Entity Type:Organization
Organization Name:ANIL A. DARA M.D. P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR
Authorized Official - Prefix:
Authorized Official - First Name:ANIL
Authorized Official - Middle Name:A
Authorized Official - Last Name:DARA
Authorized Official - Suffix:
Authorized Official - Credentials:MDPA
Authorized Official - Phone:281-443-0148
Mailing Address - Street 1:18955 MEMORIAL NORTH STE 200
Mailing Address - Street 2:
Mailing Address - City:HUMBLE
Mailing Address - State:TX
Mailing Address - Zip Code:77338
Mailing Address - Country:US
Mailing Address - Phone:281-446-0148
Mailing Address - Fax:281-446-0149
Practice Address - Street 1:18955 MEMORIAL NORTH STE 200
Practice Address - Street 2:
Practice Address - City:HUMBLE
Practice Address - State:TX
Practice Address - Zip Code:77338
Practice Address - Country:US
Practice Address - Phone:281-446-0148
Practice Address - Fax:281-446-0149
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-06
Last Update Date:2008-11-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX00875ZMedicare PIN