Provider Demographics
NPI:1588036172
Name:DUNAWAY, MARY JANE GALLARDO (CRNA)
Entity type:Individual
Prefix:MRS
First Name:MARY JANE
Middle Name:GALLARDO
Last Name:DUNAWAY
Suffix:
Gender:F
Credentials:CRNA
Other - Prefix:MISS
Other - First Name:MARY JANE
Other - Middle Name:ABAYON
Other - Last Name:GALLARDO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:7946 N LOOP 1604 W
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78249-5174
Mailing Address - Country:US
Mailing Address - Phone:480-381-1542
Mailing Address - Fax:
Practice Address - Street 1:7946 N LOOP 1604 W
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78249-5174
Practice Address - Country:US
Practice Address - Phone:480-381-1542
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-10-22
Last Update Date:2024-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP129523367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered