Provider Demographics
NPI:1174725667
Name:TANEJA, AANCHAL (MD)
Entity type:Individual
Prefix:
First Name:AANCHAL
Middle Name:
Last Name:TANEJA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8198 WALNUT HILL LN STE 100
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75231-4316
Mailing Address - Country:US
Mailing Address - Phone:214-345-4440
Mailing Address - Fax:214-345-4286
Practice Address - Street 1:8220 WALNUT HILL LN STE 516
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75231-4433
Practice Address - Country:US
Practice Address - Phone:469-994-1817
Practice Address - Fax:469-444-6054
Is Sole Proprietor?:No
Enumeration Date:2007-06-05
Last Update Date:2021-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXN79732084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
BP1-0026352OtherINSTITUTIONAL PERMIT
BP1-0026352OtherINSTITUTIONAL PERMIT
TX268407YKPWMedicare PIN
TX268407YKQLMedicare PIN