Basic Information
Provider Information
NPI: 1356572507
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: FERNANDEZ
FirstName: ANN
MiddleName: MARIE
NamePrefix: DR.
NameSuffix:  
Credential: DO
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 909 FROSTWOOD DR STE 1.100
Address2:  
City: HOUSTON
State: TX
PostalCode: 770242301
CountryCode: US
TelephoneNumber: 7133386353
FaxNumber:  
Practice Location
Address1: 921 GESSNER RD RM 317
Address2:  
City: HOUSTON
State: TX
PostalCode: 770242501
CountryCode: US
TelephoneNumber: 7132423768
FaxNumber:  
Other Information
ProviderEnumerationDate: 08/06/2009
LastUpdateDate: 03/25/2020
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 03/25/2020

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207R00000XQ4098TXN Allopathic & Osteopathic PhysiciansInternal Medicine 
207RN0300XQ4098TXN Allopathic & Osteopathic PhysiciansInternal MedicineNephrology
208M00000XQ4098TXY Allopathic & Osteopathic PhysiciansHospitalist 

No ID Information.


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