Provider Demographics
NPI:1326373291
Name:DOGWOOD HOUSECALLS PA
Entity Type:Organization
Organization Name:DOGWOOD HOUSECALLS PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:VALERIE
Authorized Official - Middle Name:
Authorized Official - Last Name:SLOCUM
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:972-345-5678
Mailing Address - Street 1:3912 DREXEL DR
Mailing Address - Street 2:
Mailing Address - City:DENTON
Mailing Address - State:TX
Mailing Address - Zip Code:76210-7705
Mailing Address - Country:US
Mailing Address - Phone:940-395-9545
Mailing Address - Fax:
Practice Address - Street 1:3912 DREXEL DR
Practice Address - Street 2:
Practice Address - City:DENTON
Practice Address - State:TX
Practice Address - Zip Code:76210-7705
Practice Address - Country:US
Practice Address - Phone:940-395-9545
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-10-12
Last Update Date:2011-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty