Individual
ANNAROSAN PUSHPAVILASUM JOY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
5232 COLLEYVILLE BLVD, SUITE 100, COLLEYVILLE, TX 76034
(817) 912-9920
(803) 865-4932
Mailing address
5232 COLLEYVILLE BLVD, SUITE 100, COLLEYVILLE, TX 76034
(817) 912-9920
(803) 865-4932
Taxonomy
Speciality
Code
Description
License number
State
207QA0505X
Adult Medicine Physician
Primary
23437
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
234375
—
SC
Enumeration date
05/08/2006
Last updated
02/13/2023
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