Provider Demographics
NPI:1740611227
Name:MEEPE, ANUSHKA (PA)
Entity Type:Individual
Prefix:
First Name:ANUSHKA
Middle Name:
Last Name:MEEPE
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6029 BELT LINE RD
Mailing Address - Street 2:SUITE 105
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75254-9109
Mailing Address - Country:US
Mailing Address - Phone:972-385-0000
Mailing Address - Fax:
Practice Address - Street 1:6029 BELT LINE RD
Practice Address - Street 2:SUITE 105
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75254-9109
Practice Address - Country:US
Practice Address - Phone:972-385-0000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-12-09
Last Update Date:2013-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXPA-07686363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant