Provider Demographics
NPI:1023043239
Name:MORRISON, ANN M
Entity Type:Individual
Prefix:MS
First Name:ANN
Middle Name:M
Last Name:MORRISON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7777 FOREST LN
Mailing Address - Street 2:SUITE C 833
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75230-2571
Mailing Address - Country:US
Mailing Address - Phone:972-566-4591
Mailing Address - Fax:972-566-6679
Practice Address - Street 1:7777 FOREST LN
Practice Address - Street 2:SUITE C 833
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75230-2571
Practice Address - Country:US
Practice Address - Phone:972-566-4591
Practice Address - Fax:972-566-6679
Is Sole Proprietor?:No
Enumeration Date:2006-07-12
Last Update Date:2015-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXPA05669363A00000X, 363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXPA05669OtherLICENSE
PAQ63386Medicare UPIN
PA098330KE4Medicare ID - Type UnspecifiedMEDICARE NUMBER