Provider Demographics
NPI:1669675757
Name:PHILIP, ANJANA (MD)
Entity Type:Individual
Prefix:DR
First Name:ANJANA
Middle Name:
Last Name:PHILIP
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8133 MESA DR
Mailing Address - Street 2:SUITE # 204
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78759-8655
Mailing Address - Country:US
Mailing Address - Phone:512-452-2100
Mailing Address - Fax:855-836-7222
Practice Address - Street 1:8133 MESA DR
Practice Address - Street 2:SUITE # 204
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78759-8655
Practice Address - Country:US
Practice Address - Phone:512-452-2100
Practice Address - Fax:855-836-7222
Is Sole Proprietor?:No
Enumeration Date:2007-06-07
Last Update Date:2015-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ALL2847207RN0300X
ARE-6627207RN0300X
TXP1385207RN0300X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX287134501Medicaid
AR5AE49Medicare PIN
TX287134501Medicaid