Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207V00000X | Obstetrician & Gynecologist | OS013698 | PA |
N | 207VF0040X | Female Pelvic Medicine and Reconstructive Surgeon | K6640 | TX |
NPI | 1295731016 |
---|---|
Provider Name | Dr. Annmarie Mcrena Ledley |
First Address | Greenville, TX 75401-5639 |
Second Address | Greenville, TX 75401-5644 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 27/06/2005 |
Last Update Date | 10/04/2012 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
092276701 | (05) | TX |
1018018780001 | (05) | PA |
G83166 | (02) | TX |
K6640 | STATE LICENSE NUMBER (01) | TX |
OS013698 | MEDICAL LICENSE NUMBER (01) | PA |