Healthcare Provider Details
I. General information
NPI: 1043890817
Provider Name (Legal Business Name): ANAC. P.C.
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 04/14/2021
Last Update Date: 11/05/2024
Certification Date: 11/05/2024
Deactivation Date:
Reactivation Date:
III. Provider practice location address
108 JOSHUA RD
WEATHERFORD TX
76087-6036
US
IV. Provider business mailing address
PO BOX 62428
FORT MYERS FL
33906-2428
US
V. Phone/Fax
- Phone: 281-265-1776
- Fax: 239-215-0065
- Phone: 281-265-1776
- Fax: 239-215-0065
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 2084N0600X |
| Taxonomy | Clinical Neurophysiology Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
JOEL
WOLINSKY
Title or Position: PRESIDENT
Credential: M.D.
Phone: 281-265-1776