Provider Demographics
NPI:1073518031
Name:WITSON, ANNE S (MD)
Entity Type:Individual
Prefix:
First Name:ANNE
Middle Name:S
Last Name:WITSON
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:ANNE
Other - Middle Name:
Other - Last Name:SHUMATE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:PO BOX 4677
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77210-4677
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:504 MEDICAL CENTER BLVD
Practice Address - Street 2:
Practice Address - City:CONROE
Practice Address - State:TX
Practice Address - Zip Code:77304-2808
Practice Address - Country:US
Practice Address - Phone:713-481-3544
Practice Address - Fax:713-432-0221
Is Sole Proprietor?:No
Enumeration Date:2005-06-16
Last Update Date:2009-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXK0380207ZP0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical Pathology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXP00087772OtherRAILROAD MEDICARE
TXP00087772OtherRAILROAD MEDICARE
TX8375N1Medicare PIN