Provider Demographics
NPI:1578508222
Name:BHOGARAJU, ANIL KV (MD)
Entity Type:Individual
Prefix:DR
First Name:ANIL
Middle Name:KV
Last Name:BHOGARAJU
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:PO BOX 911230
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75391-1230
Mailing Address - Country:US
Mailing Address - Phone:972-997-8000
Mailing Address - Fax:972-437-9605
Practice Address - Street 1:2790 LAKE VISTA DR
Practice Address - Street 2:
Practice Address - City:LEWISVILLE
Practice Address - State:TX
Practice Address - Zip Code:75067-3884
Practice Address - Country:US
Practice Address - Phone:972-459-1300
Practice Address - Fax:972-459-1382
Is Sole Proprietor?:No
Enumeration Date:2006-06-17
Last Update Date:2011-08-25
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TXL6294207RH0003X, 207RX0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
No207RX0202XAllopathic & Osteopathic PhysiciansInternal MedicineMedical Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX158565501Medicaid
TX8R1396OtherBLUE CROSS OF TEXAS
TX158565502Medicaid
TXTXB130691Medicare PIN
TXP00033523Medicare PIN
TX8A8352Medicare PIN
H86943Medicare UPIN