Provider Demographics
NPI:1861917718
Name:DAWKINS, MEGAN AMANDA (PA-C)
Entity type:Individual
Prefix:
First Name:MEGAN
Middle Name:AMANDA
Last Name:DAWKINS
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 30662
Mailing Address - Street 2:
Mailing Address - City:MIDLAND
Mailing Address - State:TX
Mailing Address - Zip Code:79712-0662
Mailing Address - Country:US
Mailing Address - Phone:210-845-2817
Mailing Address - Fax:
Practice Address - Street 1:3501 W ILLINOIS AVE
Practice Address - Street 2:
Practice Address - City:MIDLAND
Practice Address - State:TX
Practice Address - Zip Code:79703-5606
Practice Address - Country:US
Practice Address - Phone:432-203-0200
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-08-11
Last Update Date:2020-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXPA11595363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant