MEDICARE: DR. ANTHONY W ARDEN PH.D.

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	103T00000X	Psychologist	22358	TX

General Provider Information

NPI Number	:	1508864398
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ANTHONY W ARDEN PH.D.

Provider Business Mailing Address
First Line	:	1705 S POLK ST
Second Line	:
City	:	AMARILLO
State	:	TX
Zip	:	79102-3152
Country	:	US
Telephone Number	:	806-220-2902
Fax Number	:	806-379-5333

Provider Business Practice Location Address
First Line	:	1705 S POLK ST
Second Line	:
City	:	AMARILLO
State	:	TX
Zip	:	79102-3152
Country	:	US
Telephone Number	:	806-220-2902
Fax Number	:	806-379-5333

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/14/2005
Last Update Date	:	07/09/2007

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