Provider Demographics
NPI:1104035690
Name:DOTSON, JOHN T (DC)
Entity type:Individual
Prefix:DR
First Name:JOHN
Middle Name:T
Last Name:DOTSON
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12740 HILLCREST RD
Mailing Address - Street 2:SUITE 140
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75230-2038
Mailing Address - Country:US
Mailing Address - Phone:972-679-8869
Mailing Address - Fax:
Practice Address - Street 1:12740 HILLCREST RD
Practice Address - Street 2:SUITE 140
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75230-2038
Practice Address - Country:US
Practice Address - Phone:972-679-8869
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-21
Last Update Date:2007-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX10465111N00000X, 111NN1001X, 111NS0005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
No111NN1001XChiropractic ProvidersChiropractorNutrition
No111NS0005XChiropractic ProvidersChiropractorSports Physician