MEDICARE: ANNA B VAWTER 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
1	207N00000X	Dermatology Physician	Q5593	TX

Other Identifiers

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

General Provider Information

NPI Number	:	1609985811
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ANNA B VAWTER MD

Provider Business Mailing Address
First Line	:	PO BOX 1019
Second Line	:
City	:	ALLEN
State	:	TX
Zip	:	75013-0017
Country	:	US
Telephone Number	:	972-954-5573
Fax Number	:

Provider Business Practice Location Address
First Line	:	788 S WATTERS RD STE 120
Second Line	:
City	:	ALLEN
State	:	TX
Zip	:	75013-5123
Country	:	US
Telephone Number	:	972-649-6999
Fax Number	:

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

Provider Enumeration Date	:	08/30/2006
Last Update Date	:	03/28/2018

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Directions to “ ANNA B VAWTER MD” Practice Location

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