Provider Demographics
NPI:1902866353
Name:DUNHAM, WILLIAM PAUL (ATC, LAT)
Entity Type:Individual
Prefix:MR
First Name:WILLIAM
Middle Name:PAUL
Last Name:DUNHAM
Suffix:
Gender:M
Credentials:ATC, LAT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:601 N PARK BLVD
Mailing Address - Street 2:APT 2406
Mailing Address - City:GRAPEVINE
Mailing Address - State:TX
Mailing Address - Zip Code:76051-7833
Mailing Address - Country:US
Mailing Address - Phone:817-251-2085
Mailing Address - Fax:
Practice Address - Street 1:580 S DENTON TAP RD
Practice Address - Street 2:STE 100
Practice Address - City:COPPELL
Practice Address - State:TX
Practice Address - Zip Code:75019
Practice Address - Country:US
Practice Address - Phone:972-304-9100
Practice Address - Fax:972-304-9048
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-03-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAT22542255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer