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Individual
MARISOL S ANDERSON
Active
Individual
MARISOL S ANDERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA05800
TX
363A00000X
Physician Assistant
—
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
287807601
—
TX
05
—
287807602
—
TX
05
—
287807603
—
TX
Enumeration date
07/02/2008
Last updated
04/24/2012
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