Provider Demographics
NPI:1194790949
Name:ANAYA, ALICE MARIE (MD)
Entity type:Individual
Prefix:DR
First Name:ALICE
Middle Name:MARIE
Last Name:ANAYA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:4840 VILLA ENCANTO
Mailing Address - Street 2:
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79922-1051
Mailing Address - Country:US
Mailing Address - Phone:915-742-8370
Mailing Address - Fax:
Practice Address - Street 1:5005 N PIEDRAS ST
Practice Address - Street 2:
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79920-5001
Practice Address - Country:US
Practice Address - Phone:915-569-1370
Practice Address - Fax:915-563-3745
Is Sole Proprietor?:No
Enumeration Date:2006-02-22
Last Update Date:2014-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXL4855207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine