Provider Demographics
NPI:1710980909
Name:BLACK, DAWN DICKSON (MD)
Entity Type:Individual
Prefix:DR
First Name:DAWN
Middle Name:DICKSON
Last Name:BLACK
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:7900 FANNIN ST STE 4000
Mailing Address - Street 2:OBGYN MEDICAL CENTER, PLLC
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77054-2934
Mailing Address - Country:US
Mailing Address - Phone:713-512-7500
Mailing Address - Fax:713-512-7927
Practice Address - Street 1:7900 FANNIN ST STE 4000
Practice Address - Street 2:OBGYN MEDICAL CENTER, PLLC
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77054-2934
Practice Address - Country:US
Practice Address - Phone:713-512-7500
Practice Address - Fax:713-512-7927
Is Sole Proprietor?:No
Enumeration Date:2005-05-23
Last Update Date:2015-09-15
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TXH9803207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX83041GOtherBLUE CROSS & BLUE SHIELD
TX84321JMedicare ID - Type UnspecifiedBRAZORIA
TX83041GOtherBLUE CROSS & BLUE SHIELD
TX84278JMedicare ID - Type UnspecifiedHARRIS COUNTY
TX84384JMedicare ID - Type UnspecifiedFT.BEND/MONT.