Provider Demographics
NPI:1982737102
Name:WARTHAN, MANDY LYNN (MD)
Entity Type:Individual
Prefix:DR
First Name:MANDY
Middle Name:LYNN
Last Name:WARTHAN
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:181 N RIDGE RD
Mailing Address - Street 2:STE 100
Mailing Address - City:MCKINNEY
Mailing Address - State:TX
Mailing Address - Zip Code:75071-6962
Mailing Address - Country:US
Mailing Address - Phone:972-542-4646
Mailing Address - Fax:972-542-0909
Practice Address - Street 1:5913 VIRGINIA PKWY STE 300
Practice Address - Street 2:
Practice Address - City:MCKINNEY
Practice Address - State:TX
Practice Address - Zip Code:75071-5627
Practice Address - Country:US
Practice Address - Phone:972-542-4646
Practice Address - Fax:972-542-0909
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-14
Last Update Date:2020-10-06
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TXL4959207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology