Individual
ANNA LEE PETERSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2401 S 31ST ST, TEMPLE, TX 76508-3410
(254) 724-2111
Mailing address
PO BOX 844658, DALLAS, TX 75284-4658
(254) 724-8800
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA12523
TX
Other
Enumeration date
01/02/2019
Last updated
03/10/2022
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