Individual
ANISSA G AUGUST
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
2401 S FM 51, SUITE100, DECATUR, TX 76234-3781
(940) 626-8044
(940) 626-8055
Mailing address
PO BOX 203474, DALLAS, TX 75320-3474
(940) 626-8044
(940) 626-8055
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
K7651
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
046745805
—
TX
05
—
184194202
—
TX
01
—
8AB020
BCBS
TX
Enumeration date
06/20/2006
Last updated
06/07/2019
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