Provider Demographics
NPI:1063665990
Name:BAKER, ANN MARIE ROSE (MD)
Entity type:Individual
Prefix:DR
First Name:ANN MARIE
Middle Name:ROSE
Last Name:BAKER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4503 TEXAS BLVD.
Mailing Address - Street 2:
Mailing Address - City:TEXARKANA
Mailing Address - State:TX
Mailing Address - Zip Code:75503-3026
Mailing Address - Country:US
Mailing Address - Phone:713-828-2300
Mailing Address - Fax:903-794-6743
Practice Address - Street 1:4503 TEXAS BLVD.
Practice Address - Street 2:
Practice Address - City:TEXARKANA
Practice Address - State:TX
Practice Address - Zip Code:75503-3026
Practice Address - Country:US
Practice Address - Phone:903-792-4003
Practice Address - Fax:903-794-6743
Is Sole Proprietor?:Yes
Enumeration Date:2008-10-23
Last Update Date:2022-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301093478208000000X
TXP1266208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics