Provider Demographics
NPI:1376914275
Name:BUGGAGE, DOROTHY
Entity Type:Individual
Prefix:
First Name:DOROTHY
Middle Name:
Last Name:BUGGAGE
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 1:2320 UTICA DR
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75227-8744
Mailing Address - Country:US
Mailing Address - Phone:972-375-6740
Mailing Address - Fax:
Practice Address - Street 1:2320 UTICA DR
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75227-8744
Practice Address - Country:US
Practice Address - Phone:972-375-6740
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-10-18
Last Update Date:2015-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3140N1450XNursing & Custodial Care FacilitiesSkilled Nursing FacilityNursing Care, Pediatric