Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207V00000X | Obstetrician & Gynecologist | H2350 | TX |
NPI | 1013977834 |
---|---|
Provider Name | Dr. Carl Anthony Dunn |
First Address | Dallas, TX 75284-4658 |
Second Address | Waco, TX 76710-1031 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 24/03/2006 |
Last Update Date | 07/01/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
85356F | BLUE SHIELD (01) | TX |
E34440 | (02) | TX |