Provider Demographics
NPI:1669420204
Name:EARP, DEAN A (MD)
Entity type:Individual
Prefix:DR
First Name:DEAN
Middle Name:A
Last Name:EARP
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:150 E SONTERRA BLVD
Mailing Address - Street 2:SUITE 220
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78258-4098
Mailing Address - Country:US
Mailing Address - Phone:210-481-6800
Mailing Address - Fax:210-481-1444
Practice Address - Street 1:150 E SONTERRA BLVD
Practice Address - Street 2:SUITE 220
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78258-4098
Practice Address - Country:US
Practice Address - Phone:210-481-6800
Practice Address - Fax:210-481-1444
Is Sole Proprietor?:No
Enumeration Date:2006-05-05
Last Update Date:2007-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXM7157207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX8X6461OtherBLUE CROSS BLUE SHIELD
TXH39665Medicare UPIN
TX00485YMedicare PIN