MEDICARE: SVJETLANA DOLOVCAK M.D.

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	207RR0500X	Rheumatology Physician	U9503	TX
2	207K00000X	Allergy & Immunology Physician	MD-40903	IA

General Provider Information

NPI Number	:	1144508235
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SVJETLANA DOLOVCAK M.D.

Provider Business Mailing Address
First Line	:	981 STATE HIGHWAY 121 STE 3150
Second Line	:
City	:	ALLEN
State	:	TX
Zip	:	75013-6151
Country	:	US
Telephone Number	:	972-798-8553
Fax Number	:

Provider Business Practice Location Address
First Line	:	981 STATE HIGHWAY 121 STE 3150
Second Line	:
City	:	ALLEN
State	:	TX
Zip	:	75013-6151
Country	:	US
Telephone Number	:	972-798-8553
Fax Number	:

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

Provider Enumeration Date	:	07/24/2011
Last Update Date	:	09/23/2024

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