Provider Demographics
NPI:1952417123
Name:JALUFKA, DAWN RACHELLE (OD)
Entity Type:Individual
Prefix:DR
First Name:DAWN
Middle Name:RACHELLE
Last Name:JALUFKA
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 567
Mailing Address - Street 2:
Mailing Address - City:EDNA
Mailing Address - State:TX
Mailing Address - Zip Code:77957
Mailing Address - Country:US
Mailing Address - Phone:361-782-3839
Mailing Address - Fax:361-782-3715
Practice Address - Street 1:201 N WELLS
Practice Address - Street 2:
Practice Address - City:ENDA
Practice Address - State:TX
Practice Address - Zip Code:77957
Practice Address - Country:US
Practice Address - Phone:361-782-3839
Practice Address - Fax:361-782-3715
Is Sole Proprietor?:No
Enumeration Date:2006-08-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX4492T152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
348780OtherHIGHMARK/CLARITY V
0631210001OtherDMERC
00E63NMedicare ID - Type Unspecified
0631210001OtherDMERC