Provider Demographics
NPI:1346073392
Name:DEADMAN, LIZBETH
Entity type:Individual
Prefix:
First Name:LIZBETH
Middle Name:
Last Name:DEADMAN
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:413 TEMPLE TRL
Mailing Address - Street 2:
Mailing Address - City:FORNEY
Mailing Address - State:TX
Mailing Address - Zip Code:75126-3616
Mailing Address - Country:US
Mailing Address - Phone:940-367-1195
Mailing Address - Fax:
Practice Address - Street 1:413 TEMPLE TRL
Practice Address - Street 2:
Practice Address - City:FORNEY
Practice Address - State:TX
Practice Address - Zip Code:75126-3616
Practice Address - Country:US
Practice Address - Phone:940-367-1195
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-08-24
Last Update Date:2025-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1172563363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health