Healthcare Provider Details

I. General information

NPI: 1225005705
Provider Name (Legal Business Name): ANITA R SCRIBNER MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/03/2006
Last Update Date: 09/24/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

709 HOLLYBROOK DR SUITE 4500
LONGVIEW TX
75605-2411
US

IV. Provider business mailing address

PO BOX 610393
DALLAS TX
75261-0393
US

V. Phone/Fax

Practice location:
  • Phone: 903-757-6042
  • Fax: 903-232-8187
Mailing address:
  • Phone: 903-291-6187
  • Fax: 903-237-1810

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RI0200X
TaxonomyInfectious Disease Physician
License NumberK3455
License Number StateTX
# 2
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberK3455
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: