Provider Demographics
NPI:1760686737
Name:FALLENA, MARGARITA (MD)
Entity Type:Individual
Prefix:
First Name:MARGARITA
Middle Name:
Last Name:FALLENA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:12740 HILLCREST RD STE 265
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75230-2086
Mailing Address - Country:US
Mailing Address - Phone:972-513-1410
Mailing Address - Fax:469-565-9885
Practice Address - Street 1:12740 HILLCREST RD STE 265
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75230-2086
Practice Address - Country:US
Practice Address - Phone:972-513-1410
Practice Address - Fax:469-565-9885
Is Sole Proprietor?:No
Enumeration Date:2007-06-13
Last Update Date:2024-01-24
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TXM9271207RR0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
BP3-0029767OtherINSTITUTIONAL PERMIT
TX371901YQBCMedicare PIN