Individual
ANITA MADAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
6410 FANNIN ST, SUITE 1014, HOUSTON, TX 77030-3000
(832) 325-7080
Mailing address
PO BOX 201088, HOUSTON, TX 77216-1088
(713) 500-3500
(713) 500-8630
Taxonomy
Speciality
Code
Description
License number
State
2084N0008X
Neuromuscular Medicine (Psychiatry & Neurology) Physician
Primary
FTL 43171
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
217638001
—
TX
01
—
8CQ610
BCBSTX
TX
Enumeration date
07/01/2010
Last updated
05/06/2011
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