Provider Demographics
NPI:1801417308
Name:NARAYANAN, ANISH (MD)
Entity Type:Individual
Prefix:DR
First Name:ANISH
Middle Name:
Last Name:NARAYANAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6215 VERBENA LN
Mailing Address - Street 2:
Mailing Address - City:IRVING
Mailing Address - State:TX
Mailing Address - Zip Code:75039-0104
Mailing Address - Country:US
Mailing Address - Phone:469-600-3631
Mailing Address - Fax:
Practice Address - Street 1:6215 VERBENA LN
Practice Address - Street 2:
Practice Address - City:IRVING
Practice Address - State:TX
Practice Address - Zip Code:75039-0104
Practice Address - Country:US
Practice Address - Phone:469-600-3631
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-05-06
Last Update Date:2021-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXBP100746132085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology