Provider Demographics
NPI:1043369002
Name:DEAN, JANET ANN (FNP)
Entity Type:Individual
Prefix:
First Name:JANET
Middle Name:ANN
Last Name:DEAN
Suffix:
Gender:F
Credentials:FNP
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 840853
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75284-0853
Mailing Address - Country:US
Mailing Address - Phone:469-742-9950
Mailing Address - Fax:972-548-9005
Practice Address - Street 1:6606 LBJ FWY STE 200
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75240
Practice Address - Country:US
Practice Address - Phone:972-715-5000
Practice Address - Fax:972-715-9976
Is Sole Proprietor?:No
Enumeration Date:2007-01-09
Last Update Date:2018-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP115158363LF0000X, 363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX15696734OtherTEXAS DRIVERS LICENSE
TX193845803Medicaid
TXP00479896OtherRAILROAD MEDICARE
TX8Y1789OtherBCBS
TX193845801Medicaid
TX642427OtherTSBNE
TX193845802Medicaid
TX193845803Medicaid
TXTXB149143 00339KMedicare PIN
TX8K9209Medicare PIN
TX8Y1789OtherBCBS