Provider Demographics
NPI:1780876615
Name:ANJALI VARDE D.O., P.A.
Entity type:Organization
Organization Name:ANJALI VARDE D.O., P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:ANJALI
Authorized Official - Middle Name:
Authorized Official - Last Name:VARDE
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:713-484-5974
Mailing Address - Street 1:8200 WEDNESBURY LN STE 495
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77074-2994
Mailing Address - Country:US
Mailing Address - Phone:713-484-5974
Mailing Address - Fax:
Practice Address - Street 1:8200 WEDNESBURY LN STE 495
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77074-2994
Practice Address - Country:US
Practice Address - Phone:713-484-5974
Practice Address - Fax:713-484-5518
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-14
Last Update Date:2009-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXK7931261QP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXH45184Medicare UPIN
TXOA3543Medicare PIN