Provider Demographics
NPI:1548820202
Name:MAUSS, MACKENZIE (DNP)
Entity type:Individual
Prefix:
First Name:MACKENZIE
Middle Name:
Last Name:MAUSS
Suffix:
Gender:F
Credentials:DNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:122 W JOHN CARPENTER FWY STE 420
Mailing Address - Street 2:
Mailing Address - City:IRVING
Mailing Address - State:TX
Mailing Address - Zip Code:75039-2014
Mailing Address - Country:US
Mailing Address - Phone:214-466-6376
Mailing Address - Fax:
Practice Address - Street 1:2636 W WALNUT ST
Practice Address - Street 2:
Practice Address - City:GARLAND
Practice Address - State:TX
Practice Address - Zip Code:75042-6485
Practice Address - Country:US
Practice Address - Phone:972-487-5800
Practice Address - Fax:972-487-9680
Is Sole Proprietor?:No
Enumeration Date:2019-06-15
Last Update Date:2025-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UTF06191047363LF0000X
TX1002028363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily