Provider Demographics
NPI:1922012863
Name:BATTA, ANIL K (MD)
Entity Type:Individual
Prefix:
First Name:ANIL
Middle Name:K
Last Name:BATTA
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 1:2569 HWY BUSINESS 77
Mailing Address - Street 2:
Mailing Address - City:SAN BENITO
Mailing Address - State:TX
Mailing Address - Zip Code:78586
Mailing Address - Country:US
Mailing Address - Phone:956-399-7700
Mailing Address - Fax:956-399-7702
Practice Address - Street 1:2569 HWY BUSINESS 77
Practice Address - Street 2:
Practice Address - City:SAN BENITO
Practice Address - State:TX
Practice Address - Zip Code:78586
Practice Address - Country:US
Practice Address - Phone:956-399-7700
Practice Address - Fax:956-399-7702
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-28
Last Update Date:2011-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXK3083208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX205139973OtherTAX ID #