MEDICARE: KAREN ATILEGNA DORSMAN PHD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	103G00000X	Clinical Neuropsychologist	40594	TX

General Provider Information

NPI Number	:	1043173867
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KAREN ATILEGNA DORSMAN PHD

Provider Business Mailing Address
First Line	:	3352 LEAHY DR
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75229-3852
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	5939 HARRY HINES BLVD
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75235-6246
Country	:	US
Telephone Number	:	214-645-5505
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/08/2025
Last Update Date	:	12/08/2025

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