Provider Demographics
NPI:1154803039
Name:DAWSON, ALYSSA (CRNA)
Entity type:Individual
Prefix:
First Name:ALYSSA
Middle Name:
Last Name:DAWSON
Suffix:
Gender:F
Credentials:CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:512 VICTORIA LN STE 2
Mailing Address - Street 2:
Mailing Address - City:HARLINGEN
Mailing Address - State:TX
Mailing Address - Zip Code:78550-3227
Mailing Address - Country:US
Mailing Address - Phone:956-365-4400
Mailing Address - Fax:956-365-4111
Practice Address - Street 1:512 VICTORIA LN STE 2
Practice Address - Street 2:
Practice Address - City:HARLINGEN
Practice Address - State:TX
Practice Address - Zip Code:78550-3227
Practice Address - Country:US
Practice Address - Phone:956-365-4400
Practice Address - Fax:956-365-4111
Is Sole Proprietor?:Yes
Enumeration Date:2018-09-06
Last Update Date:2020-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP138999367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified RegisteredGroup - Single Specialty