Provider Demographics
NPI:1912970187
Name:BOECKER, ANNA MARIE (MD)
Entity Type:Individual
Prefix:DR
First Name:ANNA
Middle Name:MARIE
Last Name:BOECKER
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 1:948 GRUENE RD
Mailing Address - Street 2:STE 140
Mailing Address - City:NEW BRAUNFELS
Mailing Address - State:TX
Mailing Address - Zip Code:78130-3919
Mailing Address - Country:US
Mailing Address - Phone:830-627-2700
Mailing Address - Fax:830-627-2701
Practice Address - Street 1:948 GRUENE RD, STE 140
Practice Address - Street 2:
Practice Address - City:NEW BRAUNFELS
Practice Address - State:TX
Practice Address - Zip Code:78130-3919
Practice Address - Country:US
Practice Address - Phone:830-627-2700
Practice Address - Fax:830-627-2701
Is Sole Proprietor?:No
Enumeration Date:2006-02-09
Last Update Date:2017-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXK1162208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXG93424Medicare UPIN
TX8B6724Medicare ID - Type UnspecifiedTX MEDICARE INDIV #