Provider Demographics
NPI:1477882074
Name:DABBS, KENNETH LEE (MNS)
Entity Type:Individual
Prefix:MR
First Name:KENNETH
Middle Name:LEE
Last Name:DABBS
Suffix:
Gender:M
Credentials:MNS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1140 W MAIN ST STE 1140
Mailing Address - Street 2:
Mailing Address - City:LEWISVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:75067-3470
Mailing Address - Country:US
Mailing Address - Phone:972-956-5558
Mailing Address - Fax:972-956-0578
Practice Address - Street 1:1140 W MAIN ST STE 1140
Practice Address - Street 2:
Practice Address - City:LEWISVILLE
Practice Address - State:TX
Practice Address - Zip Code:75067-3470
Practice Address - Country:US
Practice Address - Phone:972-956-5558
Practice Address - Fax:972-956-0578
Is Sole Proprietor?:No
Enumeration Date:2009-12-10
Last Update Date:2024-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP121568363LF0000X, 363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily