Provider Demographics
NPI:1265951453
Name:DUNNAHOE MANAGEMENT & HOLDINGS LLC
Entity type:Organization
Organization Name:DUNNAHOE MANAGEMENT & HOLDINGS LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:NURSE PRACTITIONER
Authorized Official - Prefix:MR
Authorized Official - First Name:NOGGY
Authorized Official - Middle Name:DAVID
Authorized Official - Last Name:JAEN
Authorized Official - Suffix:
Authorized Official - Credentials:MSN, RN, FNP-BC
Authorized Official - Phone:903-602-5009
Mailing Address - Street 1:115 W COLLIN ST
Mailing Address - Street 2:
Mailing Address - City:CORSICANA
Mailing Address - State:TX
Mailing Address - Zip Code:75110-5222
Mailing Address - Country:US
Mailing Address - Phone:903-602-5009
Mailing Address - Fax:903-602-5039
Practice Address - Street 1:115 W COLLIN ST
Practice Address - Street 2:
Practice Address - City:CORSICANA
Practice Address - State:TX
Practice Address - Zip Code:75110-5222
Practice Address - Country:US
Practice Address - Phone:903-602-5009
Practice Address - Fax:903-602-5039
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-09-19
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP134217363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXAP134217OtherNPPES