Individual
ANA ELISE LARSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
2900 E 29TH STREET, BRYAN, TX 77802-2622
(979) 776-8440
Mailing address
2900 E 29TH STREET, BRYAN, TX 77802-2622
(979) 776-8440
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
BP10084693
TX
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/05/2023
Last updated
03/29/2024
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