Provider Demographics
NPI:1508561747
Name:ANEES, NIDA
Entity Type:Individual
Prefix:
First Name:NIDA
Middle Name:
Last Name:ANEES
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 5726
Mailing Address - Street 2:
Mailing Address - City:FRISCO
Mailing Address - State:TX
Mailing Address - Zip Code:75035-0221
Mailing Address - Country:US
Mailing Address - Phone:972-408-5634
Mailing Address - Fax:
Practice Address - Street 1:3417 GASTON AVE STE 790
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75246-2031
Practice Address - Country:US
Practice Address - Phone:214-821-5266
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-04-04
Last Update Date:2023-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant