Provider Demographics
NPI:1811423767
Name:FRESQUEZ, ARIANNA (MD)
Entity Type:Individual
Prefix:
First Name:ARIANNA
Middle Name:
Last Name:FRESQUEZ
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 1:1018 N MOUND ST STE 202
Mailing Address - Street 2:
Mailing Address - City:NACOGDOCHES
Mailing Address - State:TX
Mailing Address - Zip Code:75961-4434
Mailing Address - Country:US
Mailing Address - Phone:936-568-8425
Mailing Address - Fax:
Practice Address - Street 1:1018 N MOUND ST STE 206
Practice Address - Street 2:
Practice Address - City:NACOGDOCHES
Practice Address - State:TX
Practice Address - Zip Code:75961-4434
Practice Address - Country:US
Practice Address - Phone:936-560-2763
Practice Address - Fax:936-560-2908
Is Sole Proprietor?:Yes
Enumeration Date:2017-05-11
Last Update Date:2023-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK33143207V00000X
TXT0784207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology