Provider Demographics
NPI:1770574105
Name:GARMON, ANESIA K (DO)
Entity type:Individual
Prefix:DR
First Name:ANESIA
Middle Name:K
Last Name:GARMON
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:929 HILLTOP DR
Mailing Address - Street 2:
Mailing Address - City:WEATHERFORD
Mailing Address - State:TX
Mailing Address - Zip Code:76086-5845
Mailing Address - Country:US
Mailing Address - Phone:817-341-7626
Mailing Address - Fax:817-596-9771
Practice Address - Street 1:902 FOSTER LN
Practice Address - Street 2:
Practice Address - City:WEATHERFORD
Practice Address - State:TX
Practice Address - Zip Code:76086-5714
Practice Address - Country:US
Practice Address - Phone:817-341-7626
Practice Address - Fax:817-596-9771
Is Sole Proprietor?:No
Enumeration Date:2005-11-03
Last Update Date:2016-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXE3278207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX033831101Medicaid
A66602Medicare UPIN
TX00HA57Medicare PIN