Provider Demographics
NPI:1114931045
Name:ANWAR, KASHIF (MD)
Entity Type:Individual
Prefix:DR
First Name:KASHIF
Middle Name:
Last Name:ANWAR
Suffix:
Gender:M
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:PO BOX 203032
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:TX
Mailing Address - Zip Code:76006-9132
Mailing Address - Country:US
Mailing Address - Phone:817-460-7911
Mailing Address - Fax:817-460-5485
Practice Address - Street 1:717 N FIELDER RD
Practice Address - Street 2:
Practice Address - City:ARLINGTON
Practice Address - State:TX
Practice Address - Zip Code:76012-4636
Practice Address - Country:US
Practice Address - Phone:817-460-7911
Practice Address - Fax:817-460-5485
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-28
Last Update Date:2015-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS19379208000000X
TXN8606208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX092437501Medicaid