Provider Demographics
NPI:1063551216
Name:LANIER, PATRICIA ANNE (DDS)
Entity type:Individual
Prefix:DR
First Name:PATRICIA
Middle Name:ANNE
Last Name:LANIER
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2501 65TH STREET
Mailing Address - Street 2:
Mailing Address - City:GALVESTON
Mailing Address - State:TX
Mailing Address - Zip Code:77551
Mailing Address - Country:US
Mailing Address - Phone:409-744-4551
Mailing Address - Fax:409-744-5702
Practice Address - Street 1:2501 65TH STREET
Practice Address - Street 2:
Practice Address - City:GALVESTON
Practice Address - State:TX
Practice Address - Zip Code:77551
Practice Address - Country:US
Practice Address - Phone:409-744-4551
Practice Address - Fax:409-744-5702
Is Sole Proprietor?:No
Enumeration Date:2007-02-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX151231223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXDENT 24368Medicaid