MEDICARE: MS. DEANNA MICHELE HAYWOOD

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	347C00000X	Private Vehicle		TX

General Provider Information

NPI Number	:	1780547950
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. DEANNA MICHELE HAYWOOD

Provider Business Mailing Address
First Line	:	3839 MCKINNEY AVE STE 155
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75204-1488
Country	:	US
Telephone Number	:	469-653-7200
Fax Number	:

Provider Business Practice Location Address
First Line	:	3839 MCKINNEY AVE STE 155
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75204-1488
Country	:	US
Telephone Number	:	469-653-7200
Fax Number	:

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

Provider Enumeration Date	:	12/04/2025
Last Update Date	:	02/08/2026

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