Provider Demographics
NPI:1447240643
Name:DEAN, STEVEN E (CRNA)
Entity Type:Individual
Prefix:
First Name:STEVEN
Middle Name:E
Last Name:DEAN
Suffix:
Gender:M
Credentials:CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3005 VOLTAIRE BLVD
Mailing Address - Street 2:
Mailing Address - City:MCKINNEY
Mailing Address - State:TX
Mailing Address - Zip Code:75070-4246
Mailing Address - Country:US
Mailing Address - Phone:972-562-6630
Mailing Address - Fax:972-547-6835
Practice Address - Street 1:3005 VOLTAIRE BLVD
Practice Address - Street 2:
Practice Address - City:MCKINNEY
Practice Address - State:TX
Practice Address - Zip Code:75070-4246
Practice Address - Country:US
Practice Address - Phone:972-562-6630
Practice Address - Fax:972-547-6835
Is Sole Proprietor?:No
Enumeration Date:2005-10-27
Last Update Date:2013-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX033822367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX088926304Medicaid
TX89999COtherBCBS
TX088926301Medicaid
TX088926303Medicaid
TX088926302Medicaid
TX89999COtherBCBS
TX088926302Medicaid
TXTXB145726Medicare PIN
TX84726KMedicare PIN