1659329365 NPI number — DALE C. DUNN, MD PA

Table of content: (NPI 1659329365)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1659329365 NPI number — DALE C. DUNN, MD PA

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
DALE C. DUNN, MD PA
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

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:
1659329365
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
01/17/2013
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
3411 UNIVERSITY AVE
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
LUBBOCK
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
79413-2438
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
806-796-0507
Provider Business Mailing Address Fax Number:
806-799-6908

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1700 COGDELL BLVD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
SNYDER
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
79549-6162
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
325-574-4353
Provider Business Practice Location Address Fax Number:
325-574-2571
Provider Enumeration Date:
05/05/2006

Additional Information

Authorized Official

Authorized Official Last Name:
DUNN
Authorized Official First Name:
DALE
Authorized Official Middle Name:
CLAUDER
Authorized Official Title or Position:
DIRECTOR/PRESIDENT
Authorized Official Telephone Number:
325-574-4353

Provider Taxonomy Codes

  • Taxonomy code: 207Q00000X , with the licence number:  M1646 , registered in the state of TX ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





Copyright © 2007-2025 www.npivalidator.com