MEDICARE: LANCE TYLER DEAN LCSW

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1041C0700X	Clinical Social Worker	111478	TX

General Provider Information

NPI Number	:	1144173816
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LANCE TYLER DEAN LCSW

Provider Business Mailing Address
First Line	:	6800 PARK TEN BLVD STE 200S
Second Line	:
City	:	SAN ANTONIO
State	:	TX
Zip	:	78213-4293
Country	:	US
Telephone Number	:	210-261-1060
Fax Number	:	210-261-1973

Provider Business Practice Location Address
First Line	:	6812 BANDERA RD
Second Line	:
City	:	SAN ANTONIO
State	:	TX
Zip	:	78238-1369
Country	:	US
Telephone Number	:	210-261-1060
Fax Number	:	210-261-1973

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/20/2026
Last Update Date	:	04/07/2026

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