Provider Demographics
NPI:1861602583
Name:TIMITHY M DUNHAM MD PA
Entity type:Organization
Organization Name:TIMITHY M DUNHAM MD PA
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:DR.
Authorized Official - Prefix:
Authorized Official - First Name:TIMITHY
Authorized Official - Middle Name:M
Authorized Official - Last Name:DUNHAM
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:210-614-3333
Mailing Address - Street 1:7400 LOUIS PASTEUR DR STE 200
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78229-4542
Mailing Address - Country:US
Mailing Address - Phone:210-614-3333
Mailing Address - Fax:210-697-9952
Practice Address - Street 1:7400 LOUIS PASTEUR DR STE 200
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78229-4542
Practice Address - Country:US
Practice Address - Phone:210-614-3333
Practice Address - Fax:210-697-9952
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-23
Last Update Date:2020-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Multi-Specialty
No152W00000XEye and Vision Services ProvidersOptometristGroup - Multi-Specialty