Provider Demographics
NPI:1154532307
Name:JOHN, ANN KATHERINE (MD)
Entity type:Individual
Prefix:
First Name:ANN
Middle Name:KATHERINE
Last Name:JOHN
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 1:8140 N MOPAC EXPY STE 3-210
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78759-8862
Mailing Address - Country:US
Mailing Address - Phone:512-343-2292
Mailing Address - Fax:512-343-2745
Practice Address - Street 1:8140 N MOPAC EXPY STE 3-210
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78759-8862
Practice Address - Country:US
Practice Address - Phone:512-343-2292
Practice Address - Fax:512-343-2745
Is Sole Proprietor?:No
Enumeration Date:2007-05-26
Last Update Date:2024-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXM9382207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX2024317-02Medicaid
UT8CE497OtherBCBS
TX8L21865Medicare UPIN