Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207PE0004X | Emergency Medical Services | Q8160 | TX |
NPI | 1194080507 |
---|---|
Provider Name | Anil R Tahiliani |
First Address | Houston, TX 77024-2501 |
Second Address | Houston, TX 77024-2501 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 11/07/2012 |
Last Update Date | 02/05/2017 |