Provider Demographics
NPI:1922000488
Name:KHURSHID, ANWAR (MD)
Entity Type:Individual
Prefix:
First Name:ANWAR
Middle Name:
Last Name:KHURSHID
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:PO BOX 911230
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75391-1230
Mailing Address - Country:US
Mailing Address - Phone:972-997-8000
Mailing Address - Fax:972-234-2987
Practice Address - Street 1:906 W RANDOL MILL RD
Practice Address - Street 2:
Practice Address - City:ARLINGTON
Practice Address - State:TX
Practice Address - Zip Code:76012-2510
Practice Address - Country:US
Practice Address - Phone:817-261-4906
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-08-15
Last Update Date:2020-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ALSP-4207RH0003X
MA80500207RH0003X
TXK3278207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX154897609Medicaid
TX154897605Medicaid
TX154897604Medicaid
TX154897603Medicaid
TX154897601Medicaid
TX8B7832Medicare ID - Type UnspecifiedCMS
TX8L23607Medicare PIN
TX8L23491Medicare PIN
G42943Medicare UPIN
TX8L23492Medicare PIN