Organization
ANIS A ANSARI MD PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. PHIL GROCE (BILLING)
(972) 939-4646
Entity
Organization
Contact information
Practice address
1948 E HEBRON PKWY STE 110, CARROLLTON, TX 75007-1525
(972) 939-4646
(972) 939-6161
Mailing address
1948 E HEBRON PKWY STE 110, CARROLLTON, TX 75007-1525
(972) 939-4646
(972) 939-6161
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
J6857
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
080327201
—
TX
01
—
083250B01
BLUS CROSS BLUE SHIELD
TX
Enumeration date
06/27/2007
Last updated
11/18/2011
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