Provider Demographics
NPI:1295075687
Name:EDELMAN, DAWN E (MS LAC)
Entity type:Individual
Prefix:
First Name:DAWN
Middle Name:E
Last Name:EDELMAN
Suffix:
Gender:F
Credentials:MS LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9340 PENINSULA DR
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75218-2735
Mailing Address - Country:US
Mailing Address - Phone:214-681-3576
Mailing Address - Fax:214-828-4558
Practice Address - Street 1:6023 MORNINGSIDE AVE
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75206-5923
Practice Address - Country:US
Practice Address - Phone:214-681-3576
Practice Address - Fax:214-828-4558
Is Sole Proprietor?:Yes
Enumeration Date:2013-02-21
Last Update Date:2013-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXA01008171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist