Provider Demographics
NPI:1063035335
Name:DOTSON, RAIN STORM
Entity Type:Individual
Prefix:
First Name:RAIN
Middle Name:STORM
Last Name:DOTSON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:289 SPRINGS LN APT 504
Mailing Address - Street 2:
Mailing Address - City:DRIPPING SPRINGS
Mailing Address - State:TX
Mailing Address - Zip Code:78620-3480
Mailing Address - Country:US
Mailing Address - Phone:769-226-3689
Mailing Address - Fax:
Practice Address - Street 1:289 SPRINGS LN APT 504
Practice Address - Street 2:
Practice Address - City:DRIPPING SPRINGS
Practice Address - State:TX
Practice Address - Zip Code:78620-3480
Practice Address - Country:US
Practice Address - Phone:769-226-3689
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-05-21
Last Update Date:2020-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747A0650XNursing Service Related ProvidersTechnicianAttendant Care Provider