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NPI Code Detail

MEDICARE: ANNA TRISTAN

MEDICARE: ANNA TRISTAN
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
12355S0801XSpeech-Language Assistant37742TX

General Provider Information

NPI Number : 1730519125
Entity Type Code : Individual
Provider Name (Legal Business Name) : ANNA TRISTAN
Provider Business Mailing Address
First Line : 247 E SOUTHWEST PKWY APT 1005
Second Line :
City : LEWISVILLE
State : TX
Zip : 75067-8730
Country : US
Telephone Number : 956-267-3171
Fax Number :
Provider Business Practice Location Address
First Line : 190 CIVIC CIR STE 250
Second Line :
City : LEWISVILLE
State : TX
Zip : 75067-3648
Country : US
Telephone Number : 972-219-1200
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/20/2013
Last Update Date : 11/20/2013

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Directions to “ ANNA TRISTAN ” Practice Location

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