Individual
DEAN CABANSAG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1301 W 7TH ST, STE121, FORT WORTH, TX 76102-2651
(817) 348-0425
(817) 348-0455
Mailing address
PO BOX 1239, TROY, MI 48099-1239
(248) 824-6622
(248) 324-1477
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
L3255
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
184573701
—
TX
01
—
8V0064
BCBS OF TEXAS
TN
01
—
P00351435
RR MEDICARE
TX
Enumeration date
07/12/2006
Last updated
07/08/2011
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