Provider Demographics
NPI:1245863679
Name:DOPSON, DANIEL KIKUTA
Entity type:Individual
Prefix:
First Name:DANIEL
Middle Name:KIKUTA
Last Name:DOPSON
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6611 MULBERRY LN
Mailing Address - Street 2:
Mailing Address - City:MIDLOTHIAN
Mailing Address - State:TX
Mailing Address - Zip Code:76065-5263
Mailing Address - Country:US
Mailing Address - Phone:972-825-7720
Mailing Address - Fax:
Practice Address - Street 1:6611 MULBERRY LN
Practice Address - Street 2:
Practice Address - City:MIDLOTHIAN
Practice Address - State:TX
Practice Address - Zip Code:76065-5263
Practice Address - Country:US
Practice Address - Phone:972-825-7720
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-02-13
Last Update Date:2020-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer