Provider Demographics
NPI:1376871137
Name:COLIGAN, ANNA GUERRA
Entity Type:Individual
Prefix:
First Name:ANNA
Middle Name:GUERRA
Last Name:COLIGAN
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 1:4016 HIGHWAY 3
Mailing Address - Street 2:
Mailing Address - City:DICKINSON
Mailing Address - State:TX
Mailing Address - Zip Code:77539-5163
Mailing Address - Country:US
Mailing Address - Phone:281-337-3595
Mailing Address - Fax:281-337-4759
Practice Address - Street 1:4016 HIGHWAY 3
Practice Address - Street 2:
Practice Address - City:DICKINSON
Practice Address - State:TX
Practice Address - Zip Code:77539-5163
Practice Address - Country:US
Practice Address - Phone:281-337-3595
Practice Address - Fax:281-337-4759
Is Sole Proprietor?:Yes
Enumeration Date:2009-12-05
Last Update Date:2009-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX31607183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist