Provider Demographics
NPI:1386844520
Name:TANDON, ANUMEHA (MD)
Entity Type:Individual
Prefix:
First Name:ANUMEHA
Middle Name:
Last Name:TANDON
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 1:621 N HALL ST
Mailing Address - Street 2:SUITE 400
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75226-1339
Mailing Address - Country:US
Mailing Address - Phone:469-800-7400
Mailing Address - Fax:469-800-7440
Practice Address - Street 1:621 N HALL ST
Practice Address - Street 2:SUITE 400
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75226-1339
Practice Address - Country:US
Practice Address - Phone:469-800-7400
Practice Address - Fax:469-800-7440
Is Sole Proprietor?:No
Enumeration Date:2007-07-24
Last Update Date:2022-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXP5240207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX328525603Medicaid
TX328525604Medicaid
TX328525603Medicaid
TX315055YKTPMedicare PIN
TX315055YU6XMedicare PIN
TX315055YKY6Medicare PIN