Provider Demographics
NPI:1669655742
Name:DAWES, CHERYL A (PT, ATC)
Entity Type:Individual
Prefix:MRS
First Name:CHERYL
Middle Name:A
Last Name:DAWES
Suffix:
Gender:F
Credentials:PT, ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 5128
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75208-9128
Mailing Address - Country:US
Mailing Address - Phone:214-941-6262
Mailing Address - Fax:214-941-6277
Practice Address - Street 1:2301 S HAMPTON RD
Practice Address - Street 2:700
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75224-1650
Practice Address - Country:US
Practice Address - Phone:214-941-6262
Practice Address - Fax:214-941-6277
Is Sole Proprietor?:No
Enumeration Date:2007-12-11
Last Update Date:2008-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1037067225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX8T4485OtherBLUE CROSS BLUE SHIELD
TXP38781Medicare UPIN
TX8T4485OtherBLUE CROSS BLUE SHIELD