Provider Demographics
NPI:1316917826
Name:KLESMIT, ANN BEATRICE (DC)
Entity type:Individual
Prefix:DR
First Name:ANN
Middle Name:BEATRICE
Last Name:KLESMIT
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2927 RIDGE ROAD
Mailing Address - Street 2:STE 111
Mailing Address - City:ROCKWALL
Mailing Address - State:TX
Mailing Address - Zip Code:75032-6672
Mailing Address - Country:US
Mailing Address - Phone:972-772-4567
Mailing Address - Fax:972-772-4569
Practice Address - Street 1:2927 RIDGE ROAD
Practice Address - Street 2:STE 111
Practice Address - City:ROCKWALL
Practice Address - State:TX
Practice Address - Zip Code:75032-6672
Practice Address - Country:US
Practice Address - Phone:972-772-4567
Practice Address - Fax:972-772-4569
Is Sole Proprietor?:No
Enumeration Date:2006-01-25
Last Update Date:2010-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX4349111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX8F6041Medicare PIN
TX601656Medicare ID - Type Unspecified
TXT14214Medicare UPIN