Provider Demographics
NPI:1164405023
Name:ANSARI, KASHIF H (MD)
Entity Type:Individual
Prefix:DR
First Name:KASHIF
Middle Name:H
Last Name:ANSARI
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 1:1610 W BAKER RD
Mailing Address - Street 2:
Mailing Address - City:BAYTOWN
Mailing Address - State:TX
Mailing Address - Zip Code:77521-2279
Mailing Address - Country:US
Mailing Address - Phone:281-837-2288
Mailing Address - Fax:281-837-2252
Practice Address - Street 1:1610 W BAKER RD
Practice Address - Street 2:
Practice Address - City:BAYTOWN
Practice Address - State:TX
Practice Address - Zip Code:77521-2279
Practice Address - Country:US
Practice Address - Phone:281-837-2288
Practice Address - Fax:281-837-2252
Is Sole Proprietor?:No
Enumeration Date:2005-11-23
Last Update Date:2009-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXL3557207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX150287403Medicaid
TX8M8310OtherBC/BS
TXH08316Medicare UPIN
TX8M8310OtherBC/BS