Provider Demographics
NPI:1154612414
Name:DOLL, ALISSA DAWN ZASTROW (MD)
Entity type:Individual
Prefix:DR
First Name:ALISSA
Middle Name:DAWN ZASTROW
Last Name:DOLL
Suffix:
Gender:F
Credentials:MD
Other - Prefix:MISS
Other - First Name:ALISSA
Other - Middle Name:D
Other - Last Name:ZASTROW
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:PO BOX 845347
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75284-5347
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:5323 HARRY HINES BLVD
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75390-7539
Practice Address - Country:US
Practice Address - Phone:989-295-6684
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-04-21
Last Update Date:2016-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXQ7677207LP3000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207LP3000XAllopathic & Osteopathic PhysiciansAnesthesiologyPediatric Anesthesiology