Provider Demographics
NPI:1023050705
Name:ANAND B. MOVVA, MD.,PA
Entity type:Organization
Organization Name:ANAND B. MOVVA, MD.,PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ANAND
Authorized Official - Middle Name:B
Authorized Official - Last Name:MOVVA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:409-735-2486
Mailing Address - Street 1:2515 TEXAS AVE
Mailing Address - Street 2:
Mailing Address - City:BRIDGE CITY
Mailing Address - State:TX
Mailing Address - Zip Code:77611-2847
Mailing Address - Country:US
Mailing Address - Phone:409-735-2486
Mailing Address - Fax:409-735-2487
Practice Address - Street 1:2515 TEXAS AVE
Practice Address - Street 2:
Practice Address - City:BRIDGE CITY
Practice Address - State:TX
Practice Address - Zip Code:77611-2847
Practice Address - Country:US
Practice Address - Phone:409-735-2486
Practice Address - Fax:409-735-2487
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-10
Last Update Date:2008-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXK9621207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX0055NTOtherBCBS
TX188035301Medicaid
TXDN5911Medicare PIN
TX00X030Medicare PIN