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General NPI Number Information
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NPI Number | 1629589957
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Entity Type | Organization
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Legal Business Name | DON C DUNLAP DOCTOR OF OSTEOPATHIC MEDICINE PA
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Dates
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Enumeration Date | 10/13/2017
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Last Update Date | 03/17/2018
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Provider Practice Location Address
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Address Line | 363 W MAIN ST
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City | LEWISVILLE
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State | TX
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Zip | 75057-3867
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Country | US
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Telephone | 972-436-4434
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Fax | 817-912-1634
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Provider Business Mailing Address
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Address Line | 2140 E SOUTHLAKE BLVD STE L-702
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City | SOUTHLAKE
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State | TX
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Zip | 76092-6516
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Country | US
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Telephone | 972-436-4434
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Fax | 817-912-1634
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Authorized Official
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Title or Position | OWNER
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Name | DR. DONALD C DUNLAP JR.
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Credential | DO
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Telephone | 972-436-4434
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | G4286
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License Number State | TX
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