Provider Demographics
NPI:1164293734
Name:WHISENANT, ANA THERESE
Entity Type:Individual
Prefix:
First Name:ANA
Middle Name:THERESE
Last Name:WHISENANT
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 1:748 N EARL RUDDER FWY
Mailing Address - Street 2:
Mailing Address - City:BRYAN
Mailing Address - State:TX
Mailing Address - Zip Code:77802-2914
Mailing Address - Country:US
Mailing Address - Phone:979-207-3636
Mailing Address - Fax:
Practice Address - Street 1:748 N EARL RUDDER FWY
Practice Address - Street 2:
Practice Address - City:BRYAN
Practice Address - State:TX
Practice Address - Zip Code:77802-2914
Practice Address - Country:US
Practice Address - Phone:979-207-3636
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-01-12
Last Update Date:2024-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX13545902251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic