Basic Information
| Provider Information | |||||||||
| NPI: | 1134396955 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | MEERASAHIB | ||||||||
| FirstName: | ANISH | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 911230 | ||||||||
| Address2: | |||||||||
| City: | DALLAS | ||||||||
| State: | TX | ||||||||
| PostalCode: | 753911230 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9729978000 | ||||||||
| FaxNumber: | 9722340813 | ||||||||
| Practice Location | |||||||||
| Address1: | 501 W MEDICAL CENTER BLVD | ||||||||
| Address2: | |||||||||
| City: | WEBSTER | ||||||||
| State: | TX | ||||||||
| PostalCode: | 775984219 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2813327505 | ||||||||
| FaxNumber: | 2813327616 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/12/2008 | ||||||||
| LastUpdateDate: | 12/13/2016 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207RH0003X | Q0673 | TX | Y | Allopathic & Osteopathic Physicians | Internal Medicine | Hematology & Oncology | 207RH0003X | 0101245551 | VA | N | Allopathic & Osteopathic Physicians | Internal Medicine | Hematology & Oncology |
ID Information
| ID | Type | State | Issuer | Description | C05754 | 01 | VA | MEDICARE GROUP | OTHER | 339208603 | 05 | TX | MEDICAID | 11354396955 | 05 | VA | MEDICAID | 339208602 | 05 | TX | MEDICAID | 1417027608 | 01 | VA | GROUP NPI | OTHER | 339208601 | 05 | TX | MEDICAID | P01415821 | 01 | TX | RAILROAD MEDICARE | OTHER |