Jimenez, Dorian Louis

Jimenez, Dorian Louis is an individual health care provider with primary practice located at 1940 Hwy 114 Suite 150 , Southlake TX 76092. He recently has 2 registered licenses in different health care specialties including Podiatric Medicine & Surgery Service Providers / Podiatrist, Podiatric Medicine & Surgery Service Providers / Foot & Ankle Surgery. Podiatric Medicine & Surgery Service Providers / Podiatrist is his primary health care specialty. Jimenez, Dorian Louis can be contacted via phone (817) 424-3668.

Contact Information

Primary practice address
1940 Hwy 114 Suite 150 Southlake TX 76092
Phone: (817) 424-3668
Fax: (817) 442-8637
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Podiatric Medicine & Surgery Service Providers / Podiatrist 213E00000X POD000998 Georgia
Podiatric Medicine & Surgery Service Providers / Foot & Ankle Surgery 213ES0103X 000998 Georgia
Podiatric Medicine & Surgery Service Providers / Podiatrist 213E00000X 2397 Texas

Profile Details

NPI number 1952397119
LBN Legal business name Jimenez, Dorian Louis
Credentials Doctor of Podiatric Medicine (DPM)
Entity Individual
Sole proprietor 1 No
Enumeration date Sep 23rd, 2005
Last updated Jul 17th, 2019 - about 5 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1952397119 NPPES
Georgia MEDICAID 582964905A
Georgia Other P00427172

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