Healthcare Provider Details

I. General information

NPI: 1386678274
Provider Name (Legal Business Name): ANNE ERVINE CAUSEY P.A.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: ANNE L ERVINE PA-C

II. Dates (important events)

Enumeration Date: 07/10/2006
Last Update Date: 03/11/2021
Certification Date: 03/11/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6411 FANNIN ST
HOUSTON TX
77030-1501
US

IV. Provider business mailing address

PO BOX 301173
DALLAS TX
75303-1173
US

V. Phone/Fax

Practice location:
  • Phone: 713-500-7878
  • Fax:
Mailing address:
  • Phone: 713-500-3500
  • Fax: 713-704-6851

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License NumberPA03598
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: