Provider Demographics
NPI:1346560562
Name:HOFER, ANNE CATHERINE (MD)
Entity type:Individual
Prefix:DR
First Name:ANNE
Middle Name:CATHERINE
Last Name:HOFER
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 1:4705 FOSTER RANCH RD
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78735-6208
Mailing Address - Country:US
Mailing Address - Phone:512-647-0566
Mailing Address - Fax:
Practice Address - Street 1:614 EAKER ST
Practice Address - Street 2:
Practice Address - City:EDEN
Practice Address - State:TX
Practice Address - Zip Code:76837
Practice Address - Country:US
Practice Address - Phone:325-869-5911
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-06-10
Last Update Date:2023-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO50943261QF0400X
TXBP10037210390200000X
TXT2625207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No261QF0400XAmbulatory Health Care FacilitiesClinic/CenterFederally Qualified Health Center (FQHC)
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO93902573Medicaid