MEDICARE: DALE A DUPAQUIER MD

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	208000000X	Pediatrics Physician	L1023	TX

General Provider Information

NPI Number	:	1467456715
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DALE A DUPAQUIER MD

Provider Business Mailing Address
First Line	:	14100 SAN PEDRO AVE STE 412
Second Line	:
City	:	SAN ANTONIO
State	:	TX
Zip	:	78232-2009
Country	:	US
Telephone Number	:	210-281-8669
Fax Number	:	210-314-5044

Provider Business Practice Location Address
First Line	:	2302 SE MILITARY DR STE 107
Second Line	:
City	:	SAN ANTONIO
State	:	TX
Zip	:	78223-3585
Country	:	US
Telephone Number	:	210-370-3176
Fax Number	:	210-314-5044

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

Provider Enumeration Date	:	06/01/2005
Last Update Date	:	10/13/2021

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Directions to “ DALE A DUPAQUIER MD” Practice Location

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