Provider Demographics
NPI:1326416801
Name:DEAN, DOROTHY A (FNP-BC)
Entity type:Individual
Prefix:
First Name:DOROTHY
Middle Name:A
Last Name:DEAN
Suffix:
Gender:F
Credentials:FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:300 S COLORADO ST STE D
Mailing Address - Street 2:
Mailing Address - City:LOCKHART
Mailing Address - State:TX
Mailing Address - Zip Code:78644-2707
Mailing Address - Country:US
Mailing Address - Phone:512-398-3936
Mailing Address - Fax:833-615-2766
Practice Address - Street 1:300 S COLORADO ST STE D
Practice Address - Street 2:
Practice Address - City:LOCKHART
Practice Address - State:TX
Practice Address - Zip Code:78644-2707
Practice Address - Country:US
Practice Address - Phone:512-398-3936
Practice Address - Fax:833-615-2766
Is Sole Proprietor?:No
Enumeration Date:2015-09-14
Last Update Date:2024-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP128238363L00000X
PASP014980363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily