Provider Demographics
NPI:1467663625
Name:LINKIEWICZ-GAWEL, ANIA J (MD)
Entity Type:Individual
Prefix:
First Name:ANIA
Middle Name:J
Last Name:LINKIEWICZ-GAWEL
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 1:2100 LAKESIDE BLVD
Mailing Address - Street 2:STE 250
Mailing Address - City:RICHARDSON
Mailing Address - State:TX
Mailing Address - Zip Code:75082-4351
Mailing Address - Country:US
Mailing Address - Phone:847-971-7467
Mailing Address - Fax:
Practice Address - Street 1:215 COVE DR
Practice Address - Street 2:
Practice Address - City:COPPELL
Practice Address - State:TX
Practice Address - Zip Code:75019-7363
Practice Address - Country:US
Practice Address - Phone:847-971-7467
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-26
Last Update Date:2016-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXN1381207LP3000X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207LP3000XAllopathic & Osteopathic PhysiciansAnesthesiologyPediatric Anesthesiology
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
Provider Identifiers
StateIdentifier IDID TypeIssuer
BP1-0026363OtherINSTITUTIONAL PERMIT