Provider Demographics
NPI:1912564857
Name:DIXIT, ANNU DEEPAK (MD)
Entity Type:Individual
Prefix:
First Name:ANNU
Middle Name:DEEPAK
Last Name:DIXIT
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 1:500 W MAIN ST STE 260
Mailing Address - Street 2:
Mailing Address - City:LEWISVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:75057-3640
Mailing Address - Country:US
Mailing Address - Phone:940-591-6700
Mailing Address - Fax:
Practice Address - Street 1:500 W MAIN ST STE 260
Practice Address - Street 2:
Practice Address - City:LEWISVILLE
Practice Address - State:TX
Practice Address - Zip Code:75057-3640
Practice Address - Country:US
Practice Address - Phone:940-591-6700
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-05-27
Last Update Date:2023-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXBP10068733390200000X
TXU3507207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program