Provider Demographics
NPI:1508962739
Name:HAQUE, ANWAR (MD)
Entity Type:Individual
Prefix:
First Name:ANWAR
Middle Name:
Last Name:HAQUE
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 1:7936 N. MACARTHUR BLVD.
Mailing Address - Street 2:APT.# 3129
Mailing Address - City:IRVING
Mailing Address - State:TX
Mailing Address - Zip Code:75063-3753
Mailing Address - Country:US
Mailing Address - Phone:972-910-0726
Mailing Address - Fax:972-910-0726
Practice Address - Street 1:7936 N. MACARTHUR BLVD.
Practice Address - Street 2:APT.# 3129
Practice Address - City:IRVING
Practice Address - State:TX
Practice Address - Zip Code:75063-3753
Practice Address - Country:US
Practice Address - Phone:972-910-0726
Practice Address - Fax:972-910-0726
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301088949207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine