Provider Demographics
NPI:1235457342
Name:DOTSON, STEVEN (DC)
Entity Type:Individual
Prefix:
First Name:STEVEN
Middle Name:
Last Name:DOTSON
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5509 COLLEYVILLE BLVD
Mailing Address - Street 2:SUITE 100
Mailing Address - City:COLLEYVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:76034-7802
Mailing Address - Country:US
Mailing Address - Phone:817-479-0055
Mailing Address - Fax:817-479-0058
Practice Address - Street 1:5509 COLLEYVILLE BLVD
Practice Address - Street 2:STE. 100
Practice Address - City:COLLEYVILLE
Practice Address - State:TX
Practice Address - Zip Code:76034-7802
Practice Address - Country:US
Practice Address - Phone:817-479-0055
Practice Address - Fax:817-479-0058
Is Sole Proprietor?:No
Enumeration Date:2010-05-13
Last Update Date:2015-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY5240111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY7100122890Medicaid