Provider Demographics
NPI:1992806301
Name:DEAN, MARGARET M (RN, CS, GNP, MSN)
Entity type:Individual
Prefix:
First Name:MARGARET
Middle Name:M
Last Name:DEAN
Suffix:
Gender:F
Credentials:RN, CS, GNP, MSN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1400 WALLACE BLVD
Mailing Address - Street 2:
Mailing Address - City:AMARILLO
Mailing Address - State:TX
Mailing Address - Zip Code:79106-1708
Mailing Address - Country:US
Mailing Address - Phone:806-414-9100
Mailing Address - Fax:806-354-5717
Practice Address - Street 1:1400 S COULTER ST
Practice Address - Street 2:
Practice Address - City:AMARILLO
Practice Address - State:TX
Practice Address - Zip Code:79106-1786
Practice Address - Country:US
Practice Address - Phone:806-414-9100
Practice Address - Fax:806-354-5717
Is Sole Proprietor?:No
Enumeration Date:2006-09-26
Last Update Date:2014-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX249643363LG0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK200278600 AMedicaid
TX249643OtherLICENSE
TX111958805Medicaid
TX1119588-04Medicaid
TX111958806Medicaid
NM99058367Medicaid
TX1119588-04Medicaid
TX8B1886Medicare ID - Type Unspecified
TXS90970Medicare UPIN