Basic Information
| Provider Information | |||||||||
| NPI: | 1053481390 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | DHAWAN | ||||||||
| FirstName: | DENISE | ||||||||
| MiddleName: | MARIE | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 3505 SPINNAKER LN | ||||||||
| Address2: | |||||||||
| City: | BELTON | ||||||||
| State: | TX | ||||||||
| PostalCode: | 765132593 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2549398018 | ||||||||
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| Practice Location | |||||||||
| Address1: | 200 NOLA RUTH BLVD | ||||||||
| Address2: | |||||||||
| City: | HARKER HEIGHTS | ||||||||
| State: | TX | ||||||||
| PostalCode: | 765486074 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2546986629 | ||||||||
| FaxNumber: | 2546981673 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 11/08/2006 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 2080A0000X | TEMPORARY | TX | Y | Allopathic & Osteopathic Physicians | Pediatrics | Adolescent Medicine |
No ID Information.