Individual
MIKALA BROOKE ANDERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DO
Contact information
Practice address
1411 COLLEGE DR, TEXARKANA, TX 75503-3533
(903) 791-1110
(903) 791-9353
Mailing address
PO BOX 1326, MARSHALL, TX 75671-1326
(903) 927-3782
(903) 927-1764
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
S7168
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
S7168
TMB
TX
Enumeration date
06/07/2017
Last updated
08/28/2023
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