Individual
ANNE MICKLEBURGH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PAC
Contact information
Practice address
2304 MARKETPLACE DR, WACO, TX 76711-2467
(254) 202-7300
(254) 202-7350
Mailing address
PO BOX 848476, DALLAS, TX 75284-8476
(254) 202-4655
(254) 202-4697
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA02063
TX
Other
Enumeration date
04/12/2007
Last updated
09/23/2020
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