Provider Demographics
NPI:1568283455
Name:RABALAIS, ANNA MARIE (PA-C)
Entity type:Individual
Prefix:
First Name:ANNA
Middle Name:MARIE
Last Name:RABALAIS
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:220 E MEDICAL CENTER BLVD
Mailing Address - Street 2:
Mailing Address - City:WEBSTER
Mailing Address - State:TX
Mailing Address - Zip Code:77598-4319
Mailing Address - Country:US
Mailing Address - Phone:832-930-9001
Mailing Address - Fax:
Practice Address - Street 1:220 E MEDICAL CENTER BLVD
Practice Address - Street 2:
Practice Address - City:WEBSTER
Practice Address - State:TX
Practice Address - Zip Code:77598-4319
Practice Address - Country:US
Practice Address - Phone:832-930-9001
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-10-23
Last Update Date:2024-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXPA18458363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical