Provider Demographics
NPI:1053318915
Name:ACREMAN, ANNE E (MD)
Entity Type:Individual
Prefix:
First Name:ANNE
Middle Name:E
Last Name:ACREMAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7101 EASTRIDGE RD
Mailing Address - Street 2:
Mailing Address - City:ODESSA
Mailing Address - State:TX
Mailing Address - Zip Code:79765-8919
Mailing Address - Country:US
Mailing Address - Phone:432-367-8080
Mailing Address - Fax:432-366-8443
Practice Address - Street 1:4222 WENDOVER AVE
Practice Address - Street 2:SUITE 400
Practice Address - City:ODESSA
Practice Address - State:TX
Practice Address - Zip Code:79762-5945
Practice Address - Country:US
Practice Address - Phone:432-367-8080
Practice Address - Fax:432-366-8443
Is Sole Proprietor?:No
Enumeration Date:2005-07-06
Last Update Date:2012-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXG3100207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX00731DOtherBCBS
TX5650227OtherAETNA
TX133669502Medicaid
B20777Medicare UPIN
TX133669502Medicaid