Annelise Arze, MD
Individual provider Active NPI Psychiatry Physician · San Angelo, TX
NPI 1306038971 · NPPES record last updated Jul 21, 2022
Key facts
- NPI
- 1306038971
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Psychiatry Physician 2084P0800X
- License
- N3460 (TX)
- Practice address
- 1636 Hunters Glen
San Angelo, TX 76901-5008 - Phone
- (325) 949-5722
- Fax
- (325) 949-0003
- NPI assigned
- Aug 16, 2007
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 5
Medicare Care Compare profile
- Specialty
- Psychiatry
- Education
- Other, 2001
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Shannon Clinic
Practice addresses (Care Compare)
1636 Hunters Glen Rd
San Angelo, TX 76901-5008
Phone (325) 747-4700
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in TX
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20090902000608 | TX | Practitioner - Psychiatry | 6305991951 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| N3460 | TX | MD | Psychiatry Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Shannon Clinic | Current |
Accepting new patients | |
| McAllen Hospitalist Group, PLLC | Psychiatry | Current |
Accepting new patients |
| Shannon Medical Center | Past | Accepting new patients |
Locations
1102 W Trenton Rd
Edinburg, TX 78539
Phone (956) 388-6500
1636 Hunters Glen Rd
San Angelo, TX 76901
Phone (325) 949-5722
120 E Beauregard Ave
San Angelo, TX 76903
Phone (915) 658-1511
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatry Physician | 2084P0800X | N3460 | TX | Yes |
Addresses
Primary practice location
1636 Hunters Glen
San Angelo, TX 76901-5008
Mailing address
PO Box 3046
Malvern, PA 19355-0746
Phone (325) 949-5722
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 2047490-04 | Medicaid | TX |
Other providers in San Angelo, TX
- Bryndan Cruz Arredondo
- Cristal Alexis Arreola
- Griselda Ana Arteaga
- Edward J Artnak
- Nona Aryan
- Aika Arzuaga
- Tina Ashley
- Leslie Jane Ashlock
- Chelsea Lynn Ashton
- Gregory W. Ashton
All providers in San Angelo, TX · Psychiatry Physician in Texas
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 21, 2022. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.