Provider Demographics
NPI:1235158890
Name:SWAN, JANET K (MD)
Entity Type:Individual
Prefix:
First Name:JANET
Middle Name:K
Last Name:SWAN
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:PO BOX 50667
Mailing Address - Street 2:
Mailing Address - City:AMARILLO
Mailing Address - State:TX
Mailing Address - Zip Code:79159-0667
Mailing Address - Country:US
Mailing Address - Phone:800-480-1819
Mailing Address - Fax:817-334-0235
Practice Address - Street 1:2201 CIVIC CIR
Practice Address - Street 2:SUITE 503
Practice Address - City:AMARILLO
Practice Address - State:TX
Practice Address - Zip Code:79109-1817
Practice Address - Country:US
Practice Address - Phone:800-480-1819
Practice Address - Fax:817-334-0235
Is Sole Proprietor?:No
Enumeration Date:2006-07-18
Last Update Date:2014-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXG0177207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX130747201Medicaid
TXC22421Medicare UPIN
TX84G660Medicare ID - Type UnspecifiedPROVIDER