Healthcare Provider Details

I. General information

NPI: 1982609566
Provider Name (Legal Business Name): WILLIAM DAVID DUNN JR. FNP
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/20/2005
Last Update Date: 01/11/2024
Certification Date: 01/11/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2240 WINROW RD
FORT HUACHUCA AZ
85613-5080
US

IV. Provider business mailing address

2493 STATE HIGHWAY 12 E
ORANGE TX
77632-8426
US

V. Phone/Fax

Practice location:
  • Phone: 520-533-9616
  • Fax:
Mailing address:
  • Phone: 409-746-7000
  • Fax: 409-746-7016

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number650722
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: