MEDICARE: MARLA MELINDA ANAYA PA-C

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
1	363A00000X	Physician Assistant

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	13371432	OTHER	TX	DRIVER LIC.#

General Provider Information

NPI Number	:	1326277393
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MARLA MELINDA ANAYA PA-C

Provider Business Mailing Address
First Line	:	1200 E RIDGE RD
Second Line	:	MED POINT CENTER II SUITE 12
City	:	MCALLEN
State	:	TX
Zip	:	78503-1527
Country	:	US
Telephone Number	:	956-631-5333
Fax Number	:	956-631-5803

Provider Business Practice Location Address
First Line	:	1200 E RIDGE RD
Second Line	:	MED POINT CENTER II SUITE 12
City	:	MCALLEN
State	:	TX
Zip	:	78503-1527
Country	:	US
Telephone Number	:	956-631-5333
Fax Number	:	956-631-5803

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/10/2009
Last Update Date	:	12/01/2010

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