Provider Demographics
NPI:1881632602
Name:DOLAN, ELIZABETH T (MD)
Entity Type:Individual
Prefix:DR
First Name:ELIZABETH
Middle Name:T
Last Name:DOLAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10611 GARLAND RD
Mailing Address - Street 2:#210
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75218-2666
Mailing Address - Country:US
Mailing Address - Phone:214-324-2881
Mailing Address - Fax:214-328-4084
Practice Address - Street 1:10611 GARLAND RD
Practice Address - Street 2:#210
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75218-2666
Practice Address - Country:US
Practice Address - Phone:214-324-2881
Practice Address - Fax:214-328-4084
Is Sole Proprietor?:No
Enumeration Date:2006-06-03
Last Update Date:2022-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXG4992174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXD48232Medicare UPIN