Individual
MARC RICHARD DEAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
901 HEMPHILL ST., FORT WORTH, TX 76104-3111
(817) 332-4060
(817) 332-2304
Mailing address
P.O. BOX 961205, FORT WORTH, TX 76161-1205
(817) 740-8400
(817) 332-2304
Taxonomy
Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
201403
LA
207Y00000X
Otolaryngology Physician
Primary
P0970
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
282132402
—
TX
01
—
P01071869
MEDICARE RAILROAD
TX
Enumeration date
06/05/2007
Last updated
09/27/2012
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