Provider Demographics
NPI:1386846863
Name:KUSNOOR, ANITA VIJAY (MD)
Entity Type:Individual
Prefix:
First Name:ANITA
Middle Name:VIJAY
Last Name:KUSNOOR
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:1504 TAUB LOOP
Mailing Address - Street 2:2RM81 001
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77030
Mailing Address - Country:US
Mailing Address - Phone:713-873-3560
Mailing Address - Fax:713-798-6400
Practice Address - Street 1:1504 TAUB LOOP
Practice Address - Street 2:2RM81 001
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77030
Practice Address - Country:US
Practice Address - Phone:713-873-3560
Practice Address - Fax:713-798-6400
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-05
Last Update Date:2008-07-23
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
TXM6715207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
8K7895Medicare PIN