Provider Demographics
NPI:1700275005
Name:DR. JAN MARTIN DUNN, PLLC
Entity Type:Organization
Organization Name:DR. JAN MARTIN DUNN, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MARRIAGE & FAMILY THERAPIST
Authorized Official - Prefix:DR
Authorized Official - First Name:JAN
Authorized Official - Middle Name:MARTIN
Authorized Official - Last Name:DUNN
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:214-890-6637
Mailing Address - Street 1:8222 DOUGLAS AVE
Mailing Address - Street 2:SUITE 777
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75225-5923
Mailing Address - Country:US
Mailing Address - Phone:214-890-6637
Mailing Address - Fax:214-276-1380
Practice Address - Street 1:8222 DOUGLAS AVE
Practice Address - Street 2:SUITE 777
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75225-5923
Practice Address - Country:US
Practice Address - Phone:214-890-6637
Practice Address - Fax:214-276-1380
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-01-10
Last Update Date:2015-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX12149251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health