Provider Demographics
NPI:1356545917
Name:EWERT, ANNE CATHERINE (MD)
Entity type:Individual
Prefix:DR
First Name:ANNE
Middle Name:CATHERINE
Last Name:EWERT
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 1:1861 SH 276
Mailing Address - Street 2:
Mailing Address - City:ROCKWALL
Mailing Address - State:TX
Mailing Address - Zip Code:75032
Mailing Address - Country:US
Mailing Address - Phone:972-722-4992
Mailing Address - Fax:972-722-4995
Practice Address - Street 1:1861 SH 276
Practice Address - Street 2:
Practice Address - City:ROCKWALL
Practice Address - State:TX
Practice Address - Zip Code:75032
Practice Address - Country:US
Practice Address - Phone:972-722-4992
Practice Address - Fax:972-722-4995
Is Sole Proprietor?:No
Enumeration Date:2007-06-14
Last Update Date:2016-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXN2491208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX330745602Medicaid