Healthcare Provider Details

I. General information

NPI: 1790697381
Provider Name (Legal Business Name): DEMPY OVERLY APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/19/2026
Last Update Date: 09/19/2026
Certification Date: 09/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1441 EAGLE FEATHER WAY
HASLET TX
76052-1472
US

IV. Provider business mailing address

1441 EAGLE FEATHER WAY
HASLET TX
76052-1472
US

V. Phone/Fax

Practice location:
  • Phone: 248-880-7062
  • Fax:
Mailing address:
  • Phone: 248-880-7062
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number1246613
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: