Healthcare Provider Details

I. General information

NPI: 1710917901
Provider Name (Legal Business Name): MARVIN HUNTER DODSON M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/03/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8200 WALNUT HILL LN
DALLAS TX
75231-4426
US

IV. Provider business mailing address

8200 WALNUT HILL LN
DALLAS TX
75231-4426
US

V. Phone/Fax

Practice location:
  • Phone: 214-345-7355
  • Fax: 214-345-2682
Mailing address:
  • Phone: 214-345-7355
  • Fax: 214-345-2682

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License NumberEO444
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: