Provider Demographics
NPI:1942572573
Name:DAWN L SHOGREN, M.D.PA
Entity Type:Organization
Organization Name:DAWN L SHOGREN, M.D.PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:DAWN
Authorized Official - Middle Name:
Authorized Official - Last Name:SHOGREN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:972-392-2882
Mailing Address - Street 1:5485 BELT LINE RD
Mailing Address - Street 2:SUITE 160
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75254-7698
Mailing Address - Country:US
Mailing Address - Phone:972-392-2882
Mailing Address - Fax:972-392-4407
Practice Address - Street 1:5485 BELT LINE RD
Practice Address - Street 2:SUITE 160
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75254-7698
Practice Address - Country:US
Practice Address - Phone:972-392-2882
Practice Address - Fax:972-392-4407
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-01-27
Last Update Date:2012-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXG64542084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty