Healthcare Provider Details

I. General information

NPI: 1326523242
Provider Name (Legal Business Name): TEDDRICK DUNSON, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/26/2018
Last Update Date: 09/26/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4301 N MACARTHUR BLVD STE 107
IRVING TX
75038-6497
US

IV. Provider business mailing address

4301 N MACARTHUR BLVD STE 107
IRVING TX
75038-6497
US

V. Phone/Fax

Practice location:
  • Phone: 469-351-3432
  • Fax: 469-333-8025
Mailing address:
  • Phone: 469-351-3432
  • Fax: 469-333-8025

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207LP2900X
TaxonomyPain Medicine (Anesthesiology) Physician
License Number
License Number State

VIII. Authorized Official

Name: TEDDRICK L DUNSON
Title or Position: OWNER
Credential: MD
Phone: 469-351-3432