Individual
ANITA CAVE DEANDA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
706 TURTLE CREEK DR, TYLER, TX 75701-1833
(903) 593-1786
Mailing address
PO BOX 846098, DALLAS, TX 75284-6098
(903) 324-6450
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
J2529
TX
390200000X
Student in an Organized Health Care Education/Training Program
BC2690003
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
75-2616977-027
TRICARE
TX
01
—
75-2616977-042
TRICARE
TX
Enumeration date
03/06/2007
Last updated
05/12/2014
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