Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207XX0005X | Sports Medicine Orthopaedic Surgeon | 61118-20 | WI |
Y | 207XX0005X | Sports Medicine Orthopaedic Surgeon | S5363 | TX |
NPI | 1063509180 |
---|---|
Provider Name | Warren R. Dunn |
First Address | Houston, TX 77030-4509 |
Second Address | Houston, TX 77030-4509 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 09/10/2006 |
Last Update Date | 07/07/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
I12691 | (02) |