Provider Demographics
NPI:1306326954
Name:DEAN, ERIN MICHELLE (PT)
Entity type:Individual
Prefix:
First Name:ERIN
Middle Name:MICHELLE
Last Name:DEAN
Suffix:
Gender:F
Credentials:PT
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 911230
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75391-1230
Mailing Address - Country:US
Mailing Address - Phone:972-997-8000
Mailing Address - Fax:972-234-2987
Practice Address - Street 1:12221 RENFERT WAY, SUITES 120 AND 300
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78758-5444
Practice Address - Country:US
Practice Address - Phone:512-873-8900
Practice Address - Fax:512-834-8676
Is Sole Proprietor?:No
Enumeration Date:2018-08-14
Last Update Date:2020-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1307398225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX406229102Medicaid
TX406229101Medicaid