Individual
ANISA FARUK GOPALANI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
133 MEDICAL PARK LN STE B, HUNTSVILLE, TX 77340-4979
(936) 730-8833
(936) 730-8866
Mailing address
PO BOX 621004, DALLAS, TX 75262-1004
(936) 756-3464
(936) 703-5191
Taxonomy
Speciality
Code
Description
License number
State
208VP0000X
Pain Medicine Physician
Primary
00000
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
185507401
—
TX
Enumeration date
08/12/2006
Last updated
12/11/2019
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