Provider Demographics
NPI:1962690933
Name:KASHIF H. ANSARI M.D., P.A.
Entity type:Organization
Organization Name:KASHIF H. ANSARI M.D., P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:KASHIF
Authorized Official - Middle Name:H
Authorized Official - Last Name:ANSARI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:281-837-2288
Mailing Address - Street 1:1610 W BAKER RD STE A
Mailing Address - Street 2:
Mailing Address - City:BAYTOWN
Mailing Address - State:TX
Mailing Address - Zip Code:77521-2279
Mailing Address - Country:US
Mailing Address - Phone:281-837-2288
Mailing Address - Fax:281-837-2252
Practice Address - Street 1:1610 W BAKER RD STE A
Practice Address - Street 2:
Practice Address - City:BAYTOWN
Practice Address - State:TX
Practice Address - Zip Code:77521-2279
Practice Address - Country:US
Practice Address - Phone:281-837-2288
Practice Address - Fax:281-837-2252
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-04
Last Update Date:2011-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXL3557207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & OncologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX165385901Medicaid
TX00840WMedicare PIN