Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080A0000X | Adolescent Medicine | TEMPORARY | TX |
NPI | 1053481390 |
---|---|
Provider Name | Denise Marie Dhawan |
First Address | Belton, TX 76513-2593 |
Second Address | Harker Heights, TX 76548-6074 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 08/11/2006 |
Last Update Date | 08/07/2007 |