Individual
ANNALISSE FONTANA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
1935 MEDICAL DISTRICT DR, DALLAS, TX 75235-7701
(214) 456-7697
Mailing address
5323 HARRY HINES BLVD, DALLAS, TX 75390-7201
(979) 571-3190
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA16140
TX
363AM0700X
Medical Physician Assistant
PA16140
TX
363AS0400X
Surgical Physician Assistant
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Other
Enumeration date
08/06/2022
Last updated
06/25/2025
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