Provider Demographics
NPI:1134799257
Name:THURGOOD, DAWN MARIE (LAT, ATC)
Entity type:Individual
Prefix:
First Name:DAWN
Middle Name:MARIE
Last Name:THURGOOD
Suffix:
Gender:F
Credentials:LAT, ATC
Other - Prefix:
Other - First Name:DAWN
Other - Middle Name:MARIE
Other - Last Name:DORKO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:101 HILL TOP CIR
Mailing Address - Street 2:
Mailing Address - City:BURLESON
Mailing Address - State:TX
Mailing Address - Zip Code:76028-2353
Mailing Address - Country:US
Mailing Address - Phone:817-863-7108
Mailing Address - Fax:
Practice Address - Street 1:1015 N CARROLL AVE STE 100
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75204-6613
Practice Address - Country:US
Practice Address - Phone:214-887-6580
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-06-30
Last Update Date:2021-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAT86762255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer