Provider Demographics
NPI:1750365839
Name:AMIN, ANJANI NARENDRA (MD)
Entity type:Individual
Prefix:DR
First Name:ANJANI
Middle Name:NARENDRA
Last Name:AMIN
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 1:1540 W INTERSTATE 20
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:TX
Mailing Address - Zip Code:76017-5838
Mailing Address - Country:US
Mailing Address - Phone:817-472-6555
Mailing Address - Fax:817-472-6562
Practice Address - Street 1:1540 W INTERSTATE 20
Practice Address - Street 2:
Practice Address - City:ARLINGTON
Practice Address - State:TX
Practice Address - Zip Code:76017-5838
Practice Address - Country:US
Practice Address - Phone:817-472-6555
Practice Address - Fax:817-472-6562
Is Sole Proprietor?:Yes
Enumeration Date:2005-12-02
Last Update Date:2024-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXM0342207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXB102359Medicare PIN