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Individual

ANNELISE NATASHA RIBEIRO

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
M.D.

Contact information

Practice address
675 TOWN SQUARE BLVD BLDG 1A, GARLAND, TX 75040-2992
(903) 474-1983
(903) 496-0534
Mailing address
625 COUNTY ROAD 1503, ALBA, TX 75410-2638
(214) 918-0037
(844) 357-1903

Taxonomy

Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
P6255
TX
208D00000X
General Practice Physician
P6255
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
325375903
TX
05
325375904
TX
01
P6255
TEXAS MEDICAL BOARD
TX
Enumeration date
11/01/2007
Last updated
11/17/2021
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