Provider Demographics
NPI:1043214059
Name:WALKER, DEE ANNA (DDS)
Entity Type:Individual
Prefix:DR
First Name:DEE
Middle Name:ANNA
Last Name:WALKER
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:DR
Other - First Name:DEE
Other - Middle Name:ANNA
Other - Last Name:NICHOLS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DDS
Mailing Address - Street 1:P.O. BOX 366
Mailing Address - Street 2:
Mailing Address - City:CLIFTON
Mailing Address - State:TX
Mailing Address - Zip Code:76634
Mailing Address - Country:US
Mailing Address - Phone:254-675-3518
Mailing Address - Fax:254-675-1262
Practice Address - Street 1:302 SOUTH AVENUE Q
Practice Address - Street 2:
Practice Address - City:CLIFTON
Practice Address - State:TX
Practice Address - Zip Code:76634
Practice Address - Country:US
Practice Address - Phone:254-675-3518
Practice Address - Fax:254-675-1262
Is Sole Proprietor?:Yes
Enumeration Date:2005-06-08
Last Update Date:2011-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXN155821223G0001X
TX15582122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
No1223G0001XDental ProvidersDentistGeneral Practice