Provider Demographics
NPI:1063447894
Name:GRIFFIN, KAYLENE SUE DUNN (MD)
Entity type:Individual
Prefix:
First Name:KAYLENE
Middle Name:SUE DUNN
Last Name:GRIFFIN
Suffix:
Gender:
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:300 N. HIGHLAND AVE. SUITE 500
Mailing Address - Street 2:
Mailing Address - City:SHERMAN
Mailing Address - State:TX
Mailing Address - Zip Code:75092-7319
Mailing Address - Country:US
Mailing Address - Phone:903-957-0302
Mailing Address - Fax:903-893-6762
Practice Address - Street 1:300 N. HIGHLAND AVE. SUITE 500
Practice Address - Street 2:
Practice Address - City:SHERMAN
Practice Address - State:TX
Practice Address - Zip Code:75092-7319
Practice Address - Country:US
Practice Address - Phone:903-957-0302
Practice Address - Fax:903-893-6762
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-11
Last Update Date:2025-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXL0225208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX042378203Medicaid
OK100156740BMedicaid
TX200320401Medicaid
TX042378203Medicaid
TXH24736Medicare UPIN