Provider Demographics
NPI:1174596779
Name:KAHN, ANTHONY (MD)
Entity type:Individual
Prefix:
First Name:ANTHONY
Middle Name:
Last Name:KAHN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1301 BARBARA JORDAN BLVD.
Mailing Address - Street 2:SUITE 300
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78723
Mailing Address - Country:US
Mailing Address - Phone:512-478-8116
Mailing Address - Fax:512-478-9368
Practice Address - Street 1:1301 BARBARA JORDAN BLVD.
Practice Address - Street 2:SUITE 300
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78723
Practice Address - Country:US
Practice Address - Phone:512-478-8116
Practice Address - Fax:512-478-9368
Is Sole Proprietor?:No
Enumeration Date:2006-02-13
Last Update Date:2012-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXK3267207X00000X, 207XP3100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207XP3100XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryPediatric Orthopaedic Surgery
No207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX089939505OtherMEDICAID CSHCN
TX87W192OtherBCBS INDIVIDUAL #
TX0899395-04Medicaid
TX0899395-09OtherMEDICAID CSHCN ROT
TX0899395-08Medicaid
TX0899395-08Medicaid
TXTXB125391Medicare PIN