Provider Demographics
NPI:1942463179
Name:DOWDY, ANITA M (NP)
Entity Type:Individual
Prefix:
First Name:ANITA
Middle Name:M
Last Name:DOWDY
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 733784
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75373-3784
Mailing Address - Country:US
Mailing Address - Phone:682-885-6483
Mailing Address - Fax:682-885-3113
Practice Address - Street 1:4200 W UNIVERSITY DR
Practice Address - Street 2:
Practice Address - City:PROSPER
Practice Address - State:TX
Practice Address - Zip Code:75078-9805
Practice Address - Country:US
Practice Address - Phone:682-303-4200
Practice Address - Fax:682-303-4242
Is Sole Proprietor?:No
Enumeration Date:2008-07-08
Last Update Date:2022-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CANP17593363L00000X
TXAP117918363L00000X, 363LA2100X
CARN578936363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
CABA580XMedicare PIN
CACB251158Medicare PIN
CABA850YMedicare PIN