Provider Demographics
NPI:1285820753
Name:KHAWAJA N. ANWAR MD PA
Entity Type:Organization
Organization Name:KHAWAJA N. ANWAR MD PA
Other - Org Name:COOKE COUNTY MEDICAL CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:KHAWAJA
Authorized Official - Middle Name:N
Authorized Official - Last Name:ANWAR
Authorized Official - Suffix:
Authorized Official - Credentials:MD PA
Authorized Official - Phone:940-668-7231
Mailing Address - Street 1:801 N GRAND AVE STE 1
Mailing Address - Street 2:
Mailing Address - City:GAINESVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:76240-3574
Mailing Address - Country:US
Mailing Address - Phone:940-668-7231
Mailing Address - Fax:940-665-3048
Practice Address - Street 1:801 N GRAND AVE STE 1
Practice Address - Street 2:
Practice Address - City:GAINESVILLE
Practice Address - State:TX
Practice Address - Zip Code:76240-3574
Practice Address - Country:US
Practice Address - Phone:940-668-7231
Practice Address - Fax:940-665-3048
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-09-19
Last Update Date:2008-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR1300XAmbulatory Health Care FacilitiesClinic/CenterRural Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX068664901Medicaid
TX035909302Medicaid
TX035909302Medicaid
TX068664901Medicaid
TX458975Medicare Oscar/Certification