Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223P0700X | Prosthodontist | 33915 | TX |
NPI | 1255827820 |
---|---|
Provider Name | Anna Elizabeth Pitz |
First Address | San Antonio, TX 78229-3923 |
Second Address | San Antonio, TX 78229-3923 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 07/07/2018 |
Last Update Date | 07/07/2018 |