1225104508 NPI number — MRS. LINDA LEE DOTSON MA

Table of content: MRS. LINDA LEE DOTSON MA (NPI 1225104508)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1225104508 NPI number — MRS. LINDA LEE DOTSON MA

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
DOTSON
Provider First Name:
LINDA
Provider Middle Name:
LEE
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
MA
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1225104508
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/08/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
253 BLUE HERON LANE
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
HEATH
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
75032
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
214-356-2890
Provider Business Mailing Address Fax Number:
972-458-7538

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1219 ABRAMS RD
Provider Second Line Business Practice Location Address:
130
Provider Business Practice Location Address City Name:
RICHARDSON
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
75081
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
214-691-9101
Provider Business Practice Location Address Fax Number:
972-458-7538
Provider Enumeration Date:
11/28/2006

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 101Y00000X , with the licence number:  03322 , registered in the state of TX ; information, associated with the NPI states the following Primary Taxonomy Switch: "X" .
  • Taxonomy code: 101YP2500X , with the licence number: 03322 , registered in the state of TX ; information, associated with the NPI states the following Primary Taxonomy Switch: "X" .
  • Taxonomy code: 106H00000X , registered in the state of TX ; information, associated with the NPI states the following Primary Taxonomy Switch: "X" .

Other Provider's Identifiers (legacy, non-NPI)