Provider Demographics
NPI:1386678274
Name:CAUSEY, ANNE ERVINE (PA)
Entity Type:Individual
Prefix:
First Name:ANNE
Middle Name:ERVINE
Last Name:CAUSEY
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:ANNE
Other - Middle Name:L
Other - Last Name:ERVINE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA-C
Mailing Address - Street 1:PO BOX 301173
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75303-1173
Mailing Address - Country:US
Mailing Address - Phone:713-500-3500
Mailing Address - Fax:713-704-6851
Practice Address - Street 1:6411 FANNIN ST
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77030-1501
Practice Address - Country:US
Practice Address - Phone:713-500-7878
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-10
Last Update Date:2021-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXPA03598363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX8N3837OtherBCBS
TX189558301Medicaid
TX189558301Medicaid
TX970031145Medicare PIN
TXP85434Medicare UPIN