MEDICARE: KATHLEEN ANN DAWSON CRNA

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	367500000X	Certified Registered Nurse Anesthetist	103108	WI
2	367500000X	Certified Registered Nurse Anesthetist	762365	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	8753UA	OTHER	TX	BCBS

General Provider Information

NPI Number	:	1154324697
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KATHLEEN ANN DAWSON CRNA

Provider Business Mailing Address
First Line	:	PO BOX 844658
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75284-4658
Country	:	US
Telephone Number	:	800-994-0371
Fax Number	:	254-215-9722

Provider Business Practice Location Address
First Line	:	100 HILLCREST MEDICAL BLVD
Second Line	:
City	:	WACO
State	:	TX
Zip	:	76712-8897
Country	:	US
Telephone Number	:	254-202-2000
Fax Number	:

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

Provider Enumeration Date	:	05/28/2005
Last Update Date	:	09/12/2025

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