Provider Demographics
NPI:1346223005
Name:GRIFFIN, MARGO DENKE
Entity Type:Individual
Prefix:
First Name:MARGO
Middle Name:DENKE
Last Name:GRIFFIN
Suffix:
Gender:F
Credentials:
Other - Prefix:DR
Other - First Name:MARGO
Other - Middle Name:ANN
Other - Last Name:DENKE
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:11035 FM 470
Mailing Address - Street 2:
Mailing Address - City:TARPLEY
Mailing Address - State:TX
Mailing Address - Zip Code:78883-6307
Mailing Address - Country:US
Mailing Address - Phone:830-562-3379
Mailing Address - Fax:
Practice Address - Street 1:11035 FM 470
Practice Address - Street 2:
Practice Address - City:TARPLEY
Practice Address - State:TX
Practice Address - Zip Code:78883-6307
Practice Address - Country:US
Practice Address - Phone:830-562-3379
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2005-11-26
Last Update Date:2019-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXH1760207RE0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & Metabolism
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX046958702Medicaid
TX0079JLOtherBCBS PIN
TX2315180OtherALTERNATIVE ID BCBS
TX2315180OtherALTERNATIVE ID BCBS
TX00700HMedicare ID - Type Unspecified