Provider Demographics
NPI:1871041715
Name:MCCRARY, DANA LEANN (AGNP-C)
Entity type:Individual
Prefix:
First Name:DANA
Middle Name:LEANN
Last Name:MCCRARY
Suffix:
Gender:F
Credentials:AGNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3515 RICHMOND RD
Mailing Address - Street 2:
Mailing Address - City:TEXARKANA
Mailing Address - State:TX
Mailing Address - Zip Code:75503-0711
Mailing Address - Country:US
Mailing Address - Phone:903-791-9355
Mailing Address - Fax:903-793-0496
Practice Address - Street 1:4401 CORPORATE DR
Practice Address - Street 2:
Practice Address - City:TEXARKANA
Practice Address - State:TX
Practice Address - Zip Code:75503-1088
Practice Address - Country:US
Practice Address - Phone:903-223-9911
Practice Address - Fax:903-223-6380
Is Sole Proprietor?:No
Enumeration Date:2016-09-21
Last Update Date:2025-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP131971363LG0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology