Provider Demographics
NPI:1790265189
Name:ANIBOWEI, TINA (APRN, PMHNP-BC)
Entity Type:Individual
Prefix:
First Name:TINA
Middle Name:
Last Name:ANIBOWEI
Suffix:
Gender:F
Credentials:APRN, PMHNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2909 E ARKANSAS LN STE C
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:TX
Mailing Address - Zip Code:76010-6930
Mailing Address - Country:US
Mailing Address - Phone:214-984-3151
Mailing Address - Fax:469-301-9821
Practice Address - Street 1:2909 E ARKANSAS LN STE C
Practice Address - Street 2:
Practice Address - City:ARLINGTON
Practice Address - State:TX
Practice Address - Zip Code:76010-6930
Practice Address - Country:US
Practice Address - Phone:214-984-3151
Practice Address - Fax:469-301-9821
Is Sole Proprietor?:Yes
Enumeration Date:2018-08-15
Last Update Date:2023-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP137861363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health