Provider Demographics
NPI:1639113970
Name:DARA, ANIL A (MD)
Entity Type:Individual
Prefix:
First Name:ANIL
Middle Name:A
Last Name:DARA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:18648 MCKAY DR
Mailing Address - Street 2:SUITE #100
Mailing Address - City:HUMBLE
Mailing Address - State:TX
Mailing Address - Zip Code:77338-5716
Mailing Address - Country:US
Mailing Address - Phone:281-446-0148
Mailing Address - Fax:281-446-0149
Practice Address - Street 1:18648 MCKAY DR
Practice Address - Street 2:SUITE# 100
Practice Address - City:HUMBLE
Practice Address - State:TX
Practice Address - Zip Code:77338-5716
Practice Address - Country:US
Practice Address - Phone:281-446-0148
Practice Address - Fax:281-446-0149
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-16
Last Update Date:2014-06-25
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
TXK5086207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXG35203Medicare UPIN