Provider Demographics
NPI:1639609191
Name:STIRES, MAEGEN LYNN (MD)
Entity type:Individual
Prefix:DR
First Name:MAEGEN
Middle Name:LYNN
Last Name:STIRES
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 1:1441 N BECKLEY AVE
Mailing Address - Street 2:METHODIST DALLAS MED CENTER, GRADUATE MED EDUCATION
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75203-1201
Mailing Address - Country:US
Mailing Address - Phone:214-947-6700
Mailing Address - Fax:
Practice Address - Street 1:1441 N BECKLEY AVE
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75203-1201
Practice Address - Country:US
Practice Address - Phone:214-947-2331
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-06-18
Last Update Date:2018-01-26
Deactivation Date:2017-12-05
Deactivation Code:
Reactivation Date:2018-01-26
Provider Licenses
StateLicense IDTaxonomies
TXBP10060004207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology