Healthcare Provider Details

I. General information

NPI: 1912097031
Provider Name (Legal Business Name): JENNIFER L DAWSON P.A.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/13/2006
Last Update Date: 08/25/2025
Certification Date: 08/25/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2217 PARK BEND DR STE 300
AUSTIN TX
78758-5674
US

IV. Provider business mailing address

2217 PARK BEND DR STE 300
AUSTIN TX
78758-5674
US

V. Phone/Fax

Practice location:
  • Phone: 512-382-1933
  • Fax: 512-778-8000
Mailing address:
  • Phone: 512-382-1933
  • Fax: 512-778-8000

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License NumberPA58857
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number01744
License Number StateIA
# 3
Primary TaxonomyN
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number10407
License Number StateMN
# 4
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License NumberPA07670
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: