Provider Demographics
NPI:1659920601
Name:DOCTOR DASH
Entity Type:Organization
Organization Name:DOCTOR DASH
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:GENA
Authorized Official - Middle Name:
Authorized Official - Last Name:ROSS
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:210-960-2560
Mailing Address - Street 1:PO BOX 690885
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78269-0885
Mailing Address - Country:US
Mailing Address - Phone:210-960-2560
Mailing Address - Fax:210-702-3441
Practice Address - Street 1:4804 RESEARCH DR
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78240-5004
Practice Address - Country:US
Practice Address - Phone:210-960-2560
Practice Address - Fax:210-702-3441
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-09-11
Last Update Date:2019-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage TherapistGroup - Single Specialty
No347C00000XTransportation ServicesPrivate VehicleGroup - Single Specialty