Individual
ANITHA DEVI TANAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
601 N INDUSTRIAL BLVD, BEDFORD, TX 76021-5234
(817) 283-0161
Mailing address
4045 LEGACY TRL, CARROLLTON, TX 75010-6441
(214) 429-8178
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
AP136656
TX
363LF0000X
Family Nurse Practitioner
Primary
AP136656
TX
Other
Enumeration date
03/01/2018
Last updated
12/12/2025
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