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General NPI Number Information
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NPI Number | 1104712009
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Entity Type | Individual
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Provider Name | DAWSON LAMBERT GREGORY PTA
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Gender | Male
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Dates
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Enumeration Date | 06/16/2025
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Last Update Date | 06/16/2025
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Provider Practice Location Address
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Address Line | 3100 OLYMPUS BLVD STE 500
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City | COPPELL
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State | TX
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Zip | 75019-5473
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Country | US
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Telephone | 214-442-4555
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Fax | 215-243-8161
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Provider Business Mailing Address
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Address Line | 216 E BALDWIN RD UNIT B
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City | PANAMA CITY
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State | FL
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Zip | 32405-4293
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Country | US
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Telephone | 850-624-1497
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Fax |
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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 | 225200000X
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Taxonomy Name | Physical Therapy Assistant
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License Number | 32123
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License Number State | FL
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