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General NPI Number Information
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NPI Number | 1033119763
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Entity Type | Individual
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Provider Name | COLLEEN MICHELE DUNLOP JR. PA-C
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Gender | Female
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Dates
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Enumeration Date | 07/22/2005
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Last Update Date | 10/08/2013
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Provider Practice Location Address
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Address Line | 7324 SOUTHWEST FREEWAY SUITE 1550
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City | HOUSTON
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State | TX
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Zip | 77074-2053
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Country | US
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Telephone | 713-779-9800
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Fax | 713-779-9813
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Provider Business Mailing Address
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Address Line | 7324 SOUTHWEST FREEWAY SUITE 1550
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City | HOUSTON
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State | TX
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Zip | 77074-2053
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Country | US
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Telephone | 713-779-9800
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Fax | 713-779-9813
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363AS0400X
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Taxonomy Name | Surgical Physician Assistant
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License Number | 085-001342
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License Number State | IL
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Taxonomy #2
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Taxonomy Code | 363AS0400X
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Taxonomy Name | Surgical Physician Assistant
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License Number | 10000991A
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License Number State | IN
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Taxonomy #3
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Taxonomy Code | 363AS0400X
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Taxonomy Name | Surgical Physician Assistant
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License Number | 085.001342
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License Number State | IL
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