Douglas Ivan Dusenberry in Jbsa Ft Sam Houston - Surgical
Douglas Ivan Dusenberry - NPI 1790764678
Douglas Ivan Dusenberry is a Surgical in Jbsa Ft Sam Houston, Texas. Douglas Ivan Dusenberry practices all healthcare services and medical treatments related to Surgical. The NPI Number for Douglas Ivan Dusenberry is 1790764678. The last update date is 2021-08-16.
Douglas Ivan Dusenberry's current location address is 3551 Roger Brooke Dr, Jbsa Ft Sam Houston, Texas. You can contact this provider via phone number 2109165666. The mailing address for Douglas Ivan Dusenberry is 3551 Roger Brooke Dr, Jbsa Ft Sam Houston, Texas. To know further, please read the information below!
Provider Profile Detail
| Provider Name | Douglas Ivan Dusenberry |
|---|---|
| Address | 3551 Roger Brooke Dr, Jbsa Ft Sam Houston, Texas |
| Phone Number | 2109165666 |
| Fax Number | |
| Sole Proprietor | Y |
| Credentials | PA-C |
NPI Number Detail
| NPI Number | 1790764678 |
|---|---|
| Provider Enumeration Date | 2006-01-10 |
| Last Updated Date | 2021-08-16 |
Provider Mailing Address Detail
| Address | 3551 Roger Brooke Dr |
|---|---|
| City | Jbsa Ft Sam Houston |
| State | Texas (TX) |
| Post Code | 782344504 |
| Phone Number | 2109165666 |
| Fax Number |
Provider's Primary Taxonomy Detail
| Speciality | Surgical |
|---|---|
| Taxonomy | 363As0400X |
| Licence No | PA04877 |
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Definition: A licensed healthcare professional who assists in providing surgical care under physician supervision. |
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What is the unique 10-digit identifier code assigned to Douglas Ivan Dusenberry by the Centers for Medicare & Medicaid Services?
The Douglas Ivan Dusenberry has been issued the NPI (National Provider Identifier) 1790764678 by the CMS (Centers for Medicare & Medicaid Services), which serves as a unique identification number for healthcare providers.
Where is the Douglas Ivan Dusenberry located?
The Douglas Ivan Dusenberry is located at 3551 Roger Brooke Dr, Jbsa Ft Sam Houston, TX 782344504.
What is the area of specialization for Douglas Ivan Dusenberry, and what is the corresponding taxonomy classification code for this field?
The specialized field of practice for Douglas Ivan Dusenberry is Surgical, and the corresponding taxonomy code that categorizes this area of expertise is 363As0400X.
On what date did the Centers for Medicare & Medicaid Services assign the 1790764678 to Douglas Ivan Dusenberry?
The Centers for Medicare & Medicaid Services assigned the 1790764678 to Douglas Ivan Dusenberry on 2006-01-10.
As of what date were the Douglas Ivan Dusenberry's details last updated?
The information pertaining to the Douglas Ivan Dusenberry, including its address, specialty, and other details, was most recently updated on 2021-08-16.
NPI Number: 1215930425
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