Provider Demographics
NPI:1770965766
Name:PRINCE, MARGARET (RT(T))
Entity type:Individual
Prefix:
First Name:MARGARET
Middle Name:
Last Name:PRINCE
Suffix:
Gender:F
Credentials:RT(T)
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:50 HAMPTON CT
Mailing Address - Street 2:
Mailing Address - City:SEQUIM
Mailing Address - State:WA
Mailing Address - Zip Code:98382-8530
Mailing Address - Country:US
Mailing Address - Phone:407-488-0982
Mailing Address - Fax:
Practice Address - Street 1:9441 LBJ FWY STE 602
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75243-4501
Practice Address - Country:US
Practice Address - Phone:469-249-1883
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-06-25
Last Update Date:2015-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CARHT000876832471R0002X
FLCRT 544042471R0002X
MA116682471R0002X
HIT 2702471R0002X
DE78942471R0002X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2471R0002XTechnologists, Technicians & Other Technical Service ProvidersRadiologic TechnologistRadiation Therapy