Provider Demographics
NPI:1972596740
Name:CM DODSON PC
Entity Type:Organization
Organization Name:CM DODSON PC
Other - Org Name:RIO HONDO MEDICINE
Other - Org Type:Other Name
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CHERYL
Authorized Official - Middle Name:MAE
Authorized Official - Last Name:DODSON
Authorized Official - Suffix:
Authorized Official - Credentials:PA-C
Authorized Official - Phone:956-748-2381
Mailing Address - Street 1:PO BOX 1354
Mailing Address - Street 2:HWY 106
Mailing Address - City:RIO HONDO
Mailing Address - State:TX
Mailing Address - Zip Code:78583-1354
Mailing Address - Country:US
Mailing Address - Phone:956-748-2381
Mailing Address - Fax:956-748-4256
Practice Address - Street 1:HWY 106
Practice Address - Street 2:
Practice Address - City:RIO HONDO
Practice Address - State:TX
Practice Address - Zip Code:78583-1354
Practice Address - Country:US
Practice Address - Phone:956-748-2381
Practice Address - Fax:956-748-4256
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-08-26
Last Update Date:2024-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX157471701Medicaid
TX453962Medicare ID - Type Unspecified