Provider Demographics
NPI:1275631293
Name:JANJAN, NORA ANITA (MD, MPSA, MBA)
Entity Type:Individual
Prefix:DR
First Name:NORA
Middle Name:ANITA
Last Name:JANJAN
Suffix:
Gender:F
Credentials:MD, MPSA, MBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14446 HIGHWAY 6
Mailing Address - Street 2:
Mailing Address - City:NAVASOTA
Mailing Address - State:TX
Mailing Address - Zip Code:77868-6368
Mailing Address - Country:US
Mailing Address - Phone:936-825-9257
Mailing Address - Fax:
Practice Address - Street 1:14446 HIGHWAY 6
Practice Address - Street 2:
Practice Address - City:NAVASOTA
Practice Address - State:TX
Practice Address - Zip Code:77868-6368
Practice Address - Country:US
Practice Address - Phone:936-825-9257
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-09-21
Last Update Date:2010-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXF67842085R0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0001XAllopathic & Osteopathic PhysiciansRadiologyRadiation Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXP08007794Medicaid
TXP08007794Medicaid