MEDICARE: DR. JAMES MICHAEL DOOSE DDS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223P0221X	Pediatric Dentistry	18666	TX

General Provider Information

NPI Number	:	1275646275
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JAMES MICHAEL DOOSE DDS

Provider Business Mailing Address
First Line	:	2235 THOUSAND OAKS DR
Second Line	:	SUITE 122
City	:	SAN ANTONIO
State	:	TX
Zip	:	78232-3966
Country	:	US
Telephone Number	:	210-490-1133
Fax Number	:	210-490-6028

Provider Business Practice Location Address
First Line	:	2235 THOUSAND OAKS DR
Second Line	:	SUITE 122
City	:	SAN ANTONIO
State	:	TX
Zip	:	78232-3966
Country	:	US
Telephone Number	:	210-490-1133
Fax Number	:	210-490-6028

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/16/2006
Last Update Date	:	07/08/2007

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