Provider Demographics
NPI:1609373331
Name:JANISE, ANNIE KRISTIN (MD)
Entity Type:Individual
Prefix:DR
First Name:ANNIE
Middle Name:KRISTIN
Last Name:JANISE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7333 NORTH FWY STE 111
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77076-1347
Mailing Address - Country:US
Mailing Address - Phone:832-482-1200
Mailing Address - Fax:832-957-6204
Practice Address - Street 1:7333 NORTH FWY STE 111
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77076-1347
Practice Address - Country:US
Practice Address - Phone:832-482-1200
Practice Address - Fax:832-957-6204
Is Sole Proprietor?:No
Enumeration Date:2018-04-09
Last Update Date:2021-05-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXS9715207R00000X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program