Provider Demographics
NPI:1619956422
Name:VARDE, ANJALI (DO)
Entity Type:Individual
Prefix:DR
First Name:ANJALI
Middle Name:
Last Name:VARDE
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8200 WEDNESBURY LN
Mailing Address - Street 2:STE #495
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77074-2925
Mailing Address - Country:US
Mailing Address - Phone:713-484-5974
Mailing Address - Fax:713-484-5518
Practice Address - Street 1:8200 WEDNESBURY LN
Practice Address - Street 2:STE #495
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77074-2925
Practice Address - Country:US
Practice Address - Phone:713-484-5974
Practice Address - Fax:713-484-5518
Is Sole Proprietor?:Yes
Enumeration Date:2006-01-10
Last Update Date:2022-05-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXK7931207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1463960-01Medicaid
TX0040HBOtherBLUE CROSS BLUE SHIELD
TXH45184Medicare UPIN
TX1463960-01Medicaid
TX00417QMedicare ID - Type Unspecified
TX00Y257Medicare PIN