Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208000000X | Pediatrician | 242286 | NY |
N | 2080P0208X | Pediatric Infectious Diseases | 51266 | CT |
Y | 2080P0208X | Pediatric Infectious Diseases | Q2411 | TX |
NPI | 1457519027 |
---|---|
Provider Name | Dr. Dawn Marie Wetzel |
First Address | Dallas, TX 75284-5347 |
Second Address | Dallas, TX 75390-7201 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 29/05/2008 |
Last Update Date | 08/12/2014 |