Provider Demographics
NPI:1073073490
Name:GAVOR, MARGARET MAWUENA (MD)
Entity Type:Individual
Prefix:
First Name:MARGARET
Middle Name:MAWUENA
Last Name:GAVOR
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:950 E BELT LINE RD STE 150
Mailing Address - Street 2:
Mailing Address - City:CEDAR HILL
Mailing Address - State:TX
Mailing Address - Zip Code:75104-2424
Mailing Address - Country:US
Mailing Address - Phone:972-291-7863
Mailing Address - Fax:972-291-0942
Practice Address - Street 1:950 E BELT LINE RD STE 150
Practice Address - Street 2:
Practice Address - City:CEDAR HILL
Practice Address - State:TX
Practice Address - Zip Code:75104-2424
Practice Address - Country:US
Practice Address - Phone:972-291-7863
Practice Address - Fax:972-291-0942
Is Sole Proprietor?:No
Enumeration Date:2019-03-21
Last Update Date:2022-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXT8538207R00000X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program