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General NPI Number Information
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NPI Number | 1861671281
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Entity Type | Individual
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Provider Name | ANNELISE NATASHA RIBEIRO M.D.
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Gender | Female
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Dates
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Enumeration Date | 11/01/2007
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Last Update Date | 11/17/2021
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Provider Practice Location Address
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Address Line | 675 TOWN SQUARE BLVD BLDG 1A
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City | GARLAND
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State | TX
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Zip | 75040-2992
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Country | US
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Telephone | 903-474-1983
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Fax | 903-496-0534
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Provider Business Mailing Address
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Address Line | 625 COUNTY ROAD 1503
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City | ALBA
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State | TX
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Zip | 75410-2638
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Country | US
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Telephone | 214-918-0037
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Fax | 844-357-1903
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208D00000X
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Taxonomy Name | General Practice Physician
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License Number | P6255
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | P6255
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License Number State | TX
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