Provider Demographics
NPI:1053388736
Name:ANWAR, AZAM (MD)
Entity type:Individual
Prefix:DR
First Name:AZAM
Middle Name:
Last Name:ANWAR
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:16980 DALLAS PKWY
Mailing Address - Street 2:SUITE 200
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75248-1908
Mailing Address - Country:US
Mailing Address - Phone:972-391-1915
Mailing Address - Fax:972-391-2061
Practice Address - Street 1:621 N HALL ST
Practice Address - Street 2:SUITE 500
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75226-1339
Practice Address - Country:US
Practice Address - Phone:214-841-2000
Practice Address - Fax:214-841-2015
Is Sole Proprietor?:No
Enumeration Date:2006-03-02
Last Update Date:2011-06-07
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TXG6893207RI0011X, 207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0011XAllopathic & Osteopathic PhysiciansInternal MedicineInterventional Cardiology
No207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX118752801Medicaid
TX118752801Medicaid
TX85G108Medicare PIN