Provider Demographics
NPI:1134280209
Name:RHEA, DALTON LEE (MD)
Entity Type:Individual
Prefix:DR
First Name:DALTON
Middle Name:LEE
Last Name:RHEA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:703 MCKINNEY AVE
Mailing Address - Street 2:SUITE 433
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75202-1007
Mailing Address - Country:US
Mailing Address - Phone:214-754-8700
Mailing Address - Fax:214-271-4659
Practice Address - Street 1:703 MCKINNEY AVE
Practice Address - Street 2:SUITE 433
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75202-1007
Practice Address - Country:US
Practice Address - Phone:214-754-8700
Practice Address - Fax:214-271-4659
Is Sole Proprietor?:No
Enumeration Date:2006-12-13
Last Update Date:2008-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXE1245207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
00637LMedicare ID - Type Unspecified
B25900Medicare UPIN