Provider Demographics
NPI:1942314786
Name:MAYER, MARGARETA M (FNP)
Entity type:Individual
Prefix:MS
First Name:MARGARETA
Middle Name:M
Last Name:MAYER
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:MRS
Other - First Name:MARGARETA (MAILE)
Other - Middle Name:M
Other - Last Name:SHEA
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:FNP
Mailing Address - Street 1:5701 MAPLE AVE STE 100
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75235-6596
Mailing Address - Country:US
Mailing Address - Phone:214-351-6600
Mailing Address - Fax:214-351-5046
Practice Address - Street 1:5701 MAPLE AVE STE 100
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75235-6596
Practice Address - Country:US
Practice Address - Phone:214-351-6600
Practice Address - Fax:214-351-5046
Is Sole Proprietor?:No
Enumeration Date:2006-08-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX700517363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner