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NPI Code Detail

MEDICARE: ANNE V PHILIP MD

MEDICARE: ANNE V PHILIP MD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207Q00000XFamily Medicine PhysicianJ9783TX

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
28CU552OTHERTXBCBS

General Provider Information

NPI Number : 1548359771
Entity Type Code : Individual
Provider Name (Legal Business Name) : ANNE V PHILIP MD
Provider Business Mailing Address
First Line : 2100 N MAIN ST
Second Line : SUITE 110
City : FORT WORTH
State : TX
Zip : 76164-8570
Country : US
Telephone Number : 817-625-4254
Fax Number : 817-740-8612
Provider Business Practice Location Address
First Line : 2106 N MAIN ST
Second Line :
City : FORT WORTH
State : TX
Zip : 76164-8511
Country : US
Telephone Number : 817-625-4254
Fax Number : 817-740-8612
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/12/2006
Last Update Date : 10/06/2016

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