Provider Demographics
NPI:1063946978
Name:DUNN, STUART PAUL (LAT)
Entity type:Individual
Prefix:MR
First Name:STUART
Middle Name:PAUL
Last Name:DUNN
Suffix:
Gender:M
Credentials:LAT
Other - Prefix:
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Mailing Address - Street 1:1114 PHEASANT DR
Mailing Address - Street 2:
Mailing Address - City:MIDLOTHIAN
Mailing Address - State:TX
Mailing Address - Zip Code:76065-6788
Mailing Address - Country:US
Mailing Address - Phone:469-285-3500
Mailing Address - Fax:972-923-8191
Practice Address - Street 1:1200 SYCAMORE ST
Practice Address - Street 2:
Practice Address - City:WAXAHACHIE
Practice Address - State:TX
Practice Address - Zip Code:75165-2397
Practice Address - Country:US
Practice Address - Phone:469-285-3500
Practice Address - Fax:972-923-8191
Is Sole Proprietor?:Yes
Enumeration Date:2017-04-18
Last Update Date:2017-04-18
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TXAT12162255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXAT1216OtherLICENSED ATHLETIC TRAINER