Provider Demographics
NPI:1528265360
Name:DUNLAP, WADE (MD)
Entity type:Individual
Prefix:
First Name:WADE
Middle Name:
Last Name:DUNLAP
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3617 CADOGAN ST
Mailing Address - Street 2:
Mailing Address - City:MCKINNEY
Mailing Address - State:TX
Mailing Address - Zip Code:75071-6668
Mailing Address - Country:US
Mailing Address - Phone:469-617-6550
Mailing Address - Fax:
Practice Address - Street 1:7200 WYOMING SPRINGS DR STE 500
Practice Address - Street 2:
Practice Address - City:ROUND ROCK
Practice Address - State:TX
Practice Address - Zip Code:78681-4307
Practice Address - Country:US
Practice Address - Phone:512-244-0111
Practice Address - Fax:512-244-2479
Is Sole Proprietor?:No
Enumeration Date:2007-06-27
Last Update Date:2025-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WY8632A208600000X
WINONE208600000X
TXR0391208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX888877OtherMEDICARE
TX9263800OtherAETNA
TX364062503Medicaid
TX888877OtherBLUE CROSS