Provider Demographics
NPI:1639553977
Name:DODSON, TROY
Entity Type:Individual
Prefix:
First Name:TROY
Middle Name:
Last Name:DODSON
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1617 WOODHAVEN CT
Mailing Address - Street 2:
Mailing Address - City:ALLEN
Mailing Address - State:TX
Mailing Address - Zip Code:75002-6391
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:801 S GREENVILLE AVE
Practice Address - Street 2:UNIT 105
Practice Address - City:ALLEN
Practice Address - State:TX
Practice Address - Zip Code:75002-3300
Practice Address - Country:US
Practice Address - Phone:469-331-6628
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-07-16
Last Update Date:2015-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174H00000XOther Service ProvidersHealth Educator