Provider Demographics
NPI:1326514126
Name:DUSZIK, MARGARET JAN (MT)
Entity Type:Individual
Prefix:MISS
First Name:MARGARET
Middle Name:JAN
Last Name:DUSZIK
Suffix:
Gender:F
Credentials:MT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1303 LE DUKE BLVD
Mailing Address - Street 2:
Mailing Address - City:LONGVIEW
Mailing Address - State:TX
Mailing Address - Zip Code:75601-4124
Mailing Address - Country:US
Mailing Address - Phone:903-452-4915
Mailing Address - Fax:
Practice Address - Street 1:915 W LOOP 281 STE 107-12
Practice Address - Street 2:
Practice Address - City:LONGVIEW
Practice Address - State:TX
Practice Address - Zip Code:75604-2935
Practice Address - Country:US
Practice Address - Phone:903-452-4915
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-10-18
Last Update Date:2018-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXMT125918225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXMT125918OtherTEXAS DEPARTMENT OF LICENSING & REGISTRATION