MEDICARE: MS. MARGARETA M MAYER FNP

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	363L00000X	Nurse Practitioner	700517	TX

General Provider Information

NPI Number	:	1942314786
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. MARGARETA M MAYER FNP

Provider Business Mailing Address
First Line	:	5701 MAPLE AVE STE 100
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75235-6596
Country	:	US
Telephone Number	:	214-351-6600
Fax Number	:	214-351-5046

Provider Business Practice Location Address
First Line	:	5701 MAPLE AVE STE 100
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75235-6596
Country	:	US
Telephone Number	:	214-351-6600
Fax Number	:	214-351-5046

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

Provider Enumeration Date	:	08/18/2006
Last Update Date	:	07/08/2007

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