Provider Demographics
NPI:1790773042
Name:WAXALI, ANISHA VAKIL (MD)
Entity Type:Individual
Prefix:DR
First Name:ANISHA
Middle Name:VAKIL
Last Name:WAXALI
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:4780 SWEETWATER BLVD
Mailing Address - Street 2:SUITE 100
Mailing Address - City:SUGAR LAND
Mailing Address - State:TX
Mailing Address - Zip Code:77479-3162
Mailing Address - Country:US
Mailing Address - Phone:281-491-0094
Mailing Address - Fax:281-491-0111
Practice Address - Street 1:4780 SWEETWATER BLVD STE 100
Practice Address - Street 2:
Practice Address - City:SUGAR LAND
Practice Address - State:TX
Practice Address - Zip Code:77479-3163
Practice Address - Country:US
Practice Address - Phone:281-491-0094
Practice Address - Fax:281-491-0111
Is Sole Proprietor?:No
Enumeration Date:2005-10-11
Last Update Date:2022-08-23
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
TXK2133207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXG73274Medicare UPIN
TX00606V-8A9817Medicare ID - Type Unspecified