MEDICARE: ANNE M. LIPTON, M.D., PH.D., P.A.

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
1	103G00000X	Clinical Neuropsychologist	2084N0400X	TX

General Provider Information

NPI Number	:	1356462519
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ANNE M. LIPTON, M.D., PH.D., P.A.

Provider Business Mailing Address
First Line	:	7515 GREENVILLE AVE STE 503
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75231-3865
Country	:	US
Telephone Number	:	214-345-5765
Fax Number	:

Provider Business Practice Location Address
First Line	:	7515 GREENVILLE AVE STE 503
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75231-3865
Country	:	US
Telephone Number	:	214-345-5765
Fax Number	:

Authorized Official
Title or Position	:	ACCOUNT MANAGER
Name	:	JANINE MCMURTREY
Credential	:
Telephone Number	:	817-329-9812

Provider Enumeration Date	:	04/03/2007
Last Update Date	:	08/11/2008

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