Healthcare Provider Details
I. General information
NPI: 1982784211
Provider Name (Legal Business Name): JOHN F DULEMBA MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 10/17/2006
Last Update Date: 09/10/2015
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
3321 UNICORN LAKE BLVD STE 121
DENTON TX
76210-0107
US
IV. Provider business mailing address
3321 UNICORN LAKE BLVD STE 121
DENTON TX
76210-0107
US
V. Phone/Fax
- Phone: 940-387-6248
- Fax: 940-381-1881
- Phone: 940-387-6248
- Fax: 940-381-1881
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207VG0400X |
| Taxonomy | Gynecology Physician |
| License Number | H1484 |
| License Number State | TX |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: