Provider Demographics
NPI:1063581940
Name:DUNLAP, EMILY BROWN (PT)
Entity type:Individual
Prefix:
First Name:EMILY
Middle Name:BROWN
Last Name:DUNLAP
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3108 CREEKS EDGE PKWY
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78733-6335
Mailing Address - Country:US
Mailing Address - Phone:512-402-9953
Mailing Address - Fax:
Practice Address - Street 1:1927 LOHMANS CROSSING RD
Practice Address - Street 2:
Practice Address - City:LAKEWAY
Practice Address - State:TX
Practice Address - Zip Code:78734-5239
Practice Address - Country:US
Practice Address - Phone:512-261-0620
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-07
Last Update Date:2007-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1167653261QP2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX8J5939Medicare PIN