Provider Demographics
NPI:1629589957
Name:DON C DUNLAP DOCTOR OF OSTEOPATHIC MEDICINE PA
Entity Type:Organization
Organization Name:DON C DUNLAP DOCTOR OF OSTEOPATHIC MEDICINE PA
Other - Org Name:DON C DUNLAP DO PA
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:DONALD
Authorized Official - Middle Name:C
Authorized Official - Last Name:DUNLAP
Authorized Official - Suffix:JR
Authorized Official - Credentials:DO
Authorized Official - Phone:972-436-4434
Mailing Address - Street 1:2140 E SOUTHLAKE BLVD STE L-702
Mailing Address - Street 2:
Mailing Address - City:SOUTHLAKE
Mailing Address - State:TX
Mailing Address - Zip Code:76092-6516
Mailing Address - Country:US
Mailing Address - Phone:972-436-4434
Mailing Address - Fax:817-912-1634
Practice Address - Street 1:363 W MAIN ST
Practice Address - Street 2:
Practice Address - City:LEWISVILLE
Practice Address - State:TX
Practice Address - Zip Code:75057-3867
Practice Address - Country:US
Practice Address - Phone:972-436-4434
Practice Address - Fax:817-912-1634
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-10-13
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXG4286207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty