Basic Information
Provider Information
NPI: 1184604522
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: ANAND
FirstName: ADITI
MiddleName:  
NamePrefix: DR.
NameSuffix:  
Credential: MD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 14275 MIDWAY RD
Address2: SUITE 400
City: ADDISON
State: TX
PostalCode: 750013614
CountryCode: US
TelephoneNumber: 9729344300
FaxNumber: 6102714245
Practice Location
Address1: 4770 REGENT BLVD
Address2:  
City: IRVING
State: TX
PostalCode: 750632445
CountryCode: US
TelephoneNumber: 9729344300
FaxNumber: 9724551212
Other Information
ProviderEnumerationDate: 01/20/2006
LastUpdateDate: 07/21/2022
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207ZC0500XJ0879TXN Allopathic & Osteopathic PhysiciansPathologyCytopathology
207ZP0102XJ0879TXY Allopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical Pathology

ID Information
IDTypeStateIssuerDescription
14817490105TX MEDICAID


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