Provider Demographics
NPI:1194726299
Name:WHELCHEL, DAWN R (MD)
Entity type:Individual
Prefix:DR
First Name:DAWN
Middle Name:R
Last Name:WHELCHEL
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:401 E. PINECREST DR
Mailing Address - Street 2:
Mailing Address - City:MARSHALL
Mailing Address - State:TX
Mailing Address - Zip Code:75670-7207
Mailing Address - Country:US
Mailing Address - Phone:903-935-7101
Mailing Address - Fax:903-935-7043
Practice Address - Street 1:401 E PINECREST DR
Practice Address - Street 2:
Practice Address - City:MARSHALL
Practice Address - State:TX
Practice Address - Zip Code:75670-7207
Practice Address - Country:US
Practice Address - Phone:903-935-7101
Practice Address - Fax:903-935-7043
Is Sole Proprietor?:Yes
Enumeration Date:2005-08-10
Last Update Date:2011-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXL0690207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX044765801Medicaid
TX044765801Medicaid
TXH22428Medicare UPIN