Provider Demographics
NPI:1467449116
Name:ANHALT, MELVYN ALAN (MD)
Entity Type:Individual
Prefix:DR
First Name:MELVYN
Middle Name:ALAN
Last Name:ANHALT
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 1:909 FROSTWOOD DR
Mailing Address - Street 2:SUITE 1.100
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77024-2301
Mailing Address - Country:US
Mailing Address - Phone:713-338-4523
Mailing Address - Fax:
Practice Address - Street 1:915 GESSNER RD
Practice Address - Street 2:SUITE 720
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77024-2527
Practice Address - Country:US
Practice Address - Phone:713-830-9100
Practice Address - Fax:713-830-9210
Is Sole Proprietor?:No
Enumeration Date:2005-09-28
Last Update Date:2016-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXD4648208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX125035908Medicaid
TX8BP368OtherBLUECROSS BLUESHIELD OF TX
TX83C851OtherBLUE CROSS BLUE SHIELD
TX125035905Medicaid
TXP00664377OtherRAILROAD MEDICARE
TX8BP368OtherBLUECROSS BLUESHIELD OF TX
TX83C851Medicare ID - Type Unspecified
TX125035905Medicaid
TX8L5163Medicare PIN