Provider Demographics
NPI:1831149897
Name:LANDES, MARGARET B (MD)
Entity type:Individual
Prefix:
First Name:MARGARET
Middle Name:B
Last Name:LANDES
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:668 LLEWELLYN LN
Mailing Address - Street 2:
Mailing Address - City:KILLEEN
Mailing Address - State:TX
Mailing Address - Zip Code:76542-5646
Mailing Address - Country:US
Mailing Address - Phone:706-910-6343
Mailing Address - Fax:254-680-6391
Practice Address - Street 1:850 W CENTRAL TEXAS EXPY
Practice Address - Street 2:SETON MEDICAL CENTER HARKER HEIGHTS
Practice Address - City:HARKER HEIGHTS
Practice Address - State:TX
Practice Address - Zip Code:76548-1890
Practice Address - Country:US
Practice Address - Phone:254-680-6339
Practice Address - Fax:254-680-6391
Is Sole Proprietor?:No
Enumeration Date:2006-05-11
Last Update Date:2015-04-30
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CO42345208000000X
GA060928208000000X
TXN9734208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO39255522Medicaid
GA534002275AMedicaid
GA534002275AMedicaid
CO39255522Medicaid