Provider Demographics
NPI:1225005705
Name:SCRIBNER, ANITA R (MD)
Entity type:Individual
Prefix:DR
First Name:ANITA
Middle Name:R
Last Name:SCRIBNER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 610393
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75261-0393
Mailing Address - Country:US
Mailing Address - Phone:903-291-6187
Mailing Address - Fax:903-237-1810
Practice Address - Street 1:709 HOLLYBROOK DR
Practice Address - Street 2:SUITE 4500
Practice Address - City:LONGVIEW
Practice Address - State:TX
Practice Address - Zip Code:75605-2411
Practice Address - Country:US
Practice Address - Phone:903-757-6042
Practice Address - Fax:903-232-8187
Is Sole Proprietor?:No
Enumeration Date:2006-03-03
Last Update Date:2019-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXK3455207RI0200X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1043209919OtherFACILITY NPI (SHRT)
TX67-1911OtherMEDICARE PTAN FOR GROUP, SHRT
TX037728505Medicaid
TX3199986-01OtherTPI FOR GROUP SHRT
TX037728501Medicaid
TX67-1911OtherMEDICARE PTAN FOR GROUP, SHRT
TX75-2405203OtherTIN-SPECIAL HEALTH RESOURCES FOR TEXAS, INC.
TX110187916OtherRR MEDICARE