Individual
ANNE V PHILIP
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
2106 N MAIN ST, FORT WORTH, TX 76164-8511
(817) 625-4254
(817) 740-8612
Mailing address
2100 N MAIN ST, SUITE 110, FORT WORTH, TX 76164-8570
(817) 625-4254
(817) 740-8612
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
J9783
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
046176603
—
TX
01
—
8CU552
BCBS
TX
Enumeration date
10/12/2006
Last updated
10/06/2016
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