Individual
DR. ANIL K.V. BHOGARAJU
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2790 LAKE VISTA DR, LEWISVILLE, TX 75067-3884
(972) 459-1300
(972) 459-1382
Mailing address
PO BOX 911230, DALLAS, TX 75391-1230
(972) 997-8000
(972) 437-9605
Taxonomy
Speciality
Code
Description
License number
State
207RH0003X
Hematology & Oncology Physician
Primary
L6294
TX
207RX0202X
Medical Oncology Physician
L6294
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
158565501
—
TX
05
—
158565502
—
TX
01
—
8R1396
BLUE CROSS OF TEXAS
TX
Enumeration date
06/17/2006
Last updated
08/25/2011
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