Basic Information
Provider Information
NPI: 1821426925
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: BROWN
FirstName: ANNA
MiddleName: WARE
NamePrefix:  
NameSuffix:  
Credential: PSYD
OtherOrganizationName:  
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OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
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OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 8200 WALNUT HILL LN
Address2: DEPARTMENT OF PSYCHIATRY
City: DALLAS
State: TX
PostalCode: 752314426
CountryCode: US
TelephoneNumber: 2143457355
FaxNumber: 2143458753
Practice Location
Address1: 8200 WALNUT HILL LN
Address2: DEPARTMENT OF PSYCHIATRY
City: DALLAS
State: TX
PostalCode: 752314426
CountryCode: US
TelephoneNumber: 2143457355
FaxNumber: 2143458753
Other Information
ProviderEnumerationDate: 10/29/2013
LastUpdateDate: 10/29/2013
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
103T00000X36528TXY Behavioral Health & Social Service ProvidersPsychologist 

No ID Information.


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