Provider Demographics
NPI:1104846328
Name:ROTKIEWICZ, ANNA MONIKA (MD)
Entity Type:Individual
Prefix:DR
First Name:ANNA
Middle Name:MONIKA
Last Name:ROTKIEWICZ
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:5239 BEECHNUT ST
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77096-1301
Mailing Address - Country:US
Mailing Address - Phone:832-752-9085
Mailing Address - Fax:409-945-0112
Practice Address - Street 1:519 9TH AVE N
Practice Address - Street 2:
Practice Address - City:TEXAS CITY
Practice Address - State:TX
Practice Address - Zip Code:77590-6316
Practice Address - Country:US
Practice Address - Phone:832-752-9085
Practice Address - Fax:409-945-0112
Is Sole Proprietor?:No
Enumeration Date:2006-07-20
Last Update Date:2019-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXL8928207R00000X, 207RG0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0300XAllopathic & Osteopathic PhysiciansInternal MedicineGeriatric Medicine
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX180524401Medicaid
TX180524401Medicaid
I47129Medicare UPIN