Provider Demographics
NPI:1013598176
Name:DIXON, JULIANA
Entity type:Individual
Prefix:
First Name:JULIANA
Middle Name:
Last Name:DIXON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:JULIANA
Other - Middle Name:
Other - Last Name:COSTANZO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:5323 HARRY HINES BLVD
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75390-7201
Mailing Address - Country:US
Mailing Address - Phone:214-648-3111
Mailing Address - Fax:
Practice Address - Street 1:7920 ELMBROOK DR STE 120
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75247-4933
Practice Address - Country:US
Practice Address - Phone:214-266-0312
Practice Address - Fax:214-226-0449
Is Sole Proprietor?:No
Enumeration Date:2021-04-19
Last Update Date:2024-11-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXV2987207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine