Provider Demographics
NPI:1568406981
Name:KUMAR, ANAND S (OD)
Entity Type:Individual
Prefix:DR
First Name:ANAND
Middle Name:S
Last Name:KUMAR
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8202 ELAM RD
Mailing Address - Street 2:SUITE #100
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75217-4509
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:8202 ELAM RD
Practice Address - Street 2:SUITE #100
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75217-4509
Practice Address - Country:US
Practice Address - Phone:214-391-1119
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-15
Last Update Date:2008-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX06306TG152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX173179601Medicaid
TX173179601Medicaid
TX5647200001Medicare NSC
TX8D1723Medicare PIN