Provider Demographics
NPI:1508864398
Name:ARDEN, ANTHONY W (PHD)
Entity Type:Individual
Prefix:DR
First Name:ANTHONY
Middle Name:W
Last Name:ARDEN
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1705 S POLK ST
Mailing Address - Street 2:
Mailing Address - City:AMARILLO
Mailing Address - State:TX
Mailing Address - Zip Code:79102-3152
Mailing Address - Country:US
Mailing Address - Phone:806-220-2902
Mailing Address - Fax:806-379-5333
Practice Address - Street 1:1705 S POLK ST
Practice Address - Street 2:
Practice Address - City:AMARILLO
Practice Address - State:TX
Practice Address - Zip Code:79102-3152
Practice Address - Country:US
Practice Address - Phone:806-220-2902
Practice Address - Fax:806-379-5333
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-07-14
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX22358103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXR58953Medicare UPIN
TXP00213806Medicare ID - Type UnspecifiedRAILROAD MEDICARE ID
TX00SD69Medicare ID - Type UnspecifiedMEDICARE PROVIDER NUMBER