Provider Demographics
NPI:1821161050
Name:HUFF, ANGELA L (MD PA)
Entity Type:Individual
Prefix:DR
First Name:ANGELA
Middle Name:L
Last Name:HUFF
Suffix:
Gender:F
Credentials:MD PA
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:2719 BOLTON BOONE DR
Mailing Address - Street 2:
Mailing Address - City:DESOTO
Mailing Address - State:TX
Mailing Address - Zip Code:75115
Mailing Address - Country:US
Mailing Address - Phone:972-572-7893
Mailing Address - Fax:972-572-7553
Practice Address - Street 1:2719 BOLTON BOONE DR
Practice Address - Street 2:
Practice Address - City:DESOTO
Practice Address - State:TX
Practice Address - Zip Code:75115
Practice Address - Country:US
Practice Address - Phone:972-572-7893
Practice Address - Fax:972-572-7553
Is Sole Proprietor?:No
Enumeration Date:2006-11-16
Last Update Date:2011-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXJ42252084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX030608601Medicaid
TX030608601Medicaid
TX0055CAMedicare ID - Type Unspecified