Individual
ANNE ELIZABETH PRATT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
2901 N 4TH ST, ER DEPARTMENT, LONGVIEW, TX 75605-5128
(903) 757-6042
Mailing address
PO BOX 847176, DALLAS, TX 75284-7176
(903) 237-1800
(903) 237-1810
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA07060
TX
363AM0700X
Medical Physician Assistant
PA10609RX
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1624951
—
LA
05
—
286609702
—
TX
01
—
5F600P518
MEDICARE - PTAN
LA
Enumeration date
07/14/2006
Last updated
08/05/2013
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