Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208000000X | Pediatrician | N5532 | TX |
Y | 2080N0001X | Neonatal-Perinatal Doctor | N5532 | TX |
NPI | 1083872865 |
---|---|
Provider Name | Dr. Janear Rochelle Anderson |
First Address | Decatur, TX 76234-6156 |
Second Address | Bridgeport, TX 76426-2269 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 28/05/2008 |
Last Update Date | 26/10/2017 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
#8ER567 | BCBSTX (01) | TX |
326232102 | (05) | TX |