Provider Demographics
NPI:1487700381
Name:WEBB, ANNE K (OD)
Entity type:Individual
Prefix:
First Name:ANNE
Middle Name:K
Last Name:WEBB
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:MARGARET
Other - Middle Name:A
Other - Last Name:WEBB
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:OD
Mailing Address - Street 1:36 RIVER HILLS DR
Mailing Address - Street 2:
Mailing Address - City:DENISON
Mailing Address - State:TX
Mailing Address - Zip Code:75020-8223
Mailing Address - Country:US
Mailing Address - Phone:903-463-4726
Mailing Address - Fax:
Practice Address - Street 1:2634 S CARRIER PKWY STE 101
Practice Address - Street 2:
Practice Address - City:GRAND PRAIRIE
Practice Address - State:TX
Practice Address - Zip Code:75052-5005
Practice Address - Country:US
Practice Address - Phone:972-641-0011
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-01-25
Last Update Date:2007-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX2488TG152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXMWO729307Medicaid
TXMWO729307Medicaid