Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207X00000X | Orthopaedic Surgeon | M4122 | TX |
N | 207XX0004X | Foot and Ankle Orthopaedic Surgeon | M4122 | TX |
NPI | 1154306652 |
---|---|
Provider Name | Dawn M Grosser |
First Address | Plano, TX 75093-5005 |
Second Address | Plano, TX 75093-5005 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 07/12/2005 |
Last Update Date | 18/09/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1822496-02 | (05) | TX |