MEDICARE: MS. JOAN RENEE DUPUY AUD

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	231H00000X	Audiologist	81014	TX

General Provider Information

NPI Number	:	1821341462
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. JOAN RENEE DUPUY AUD

Provider Business Mailing Address
First Line	:	5000 US HIGHWAY 70 W
Second Line	:	STE 103
City	:	MOREHEAD CITY
State	:	NC
Zip	:	28557-4531
Country	:	US
Telephone Number	:	252-773-0636
Fax Number	:	877-771-3406

Provider Business Practice Location Address
First Line	:	18518 HARDY OAK BLVD STE 300
Second Line	:
City	:	SAN ANTONIO
State	:	TX
Zip	:	78258-4762
Country	:	US
Telephone Number	:	210-696-4327
Fax Number	:	210-798-2509

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

Provider Enumeration Date	:	10/19/2012
Last Update Date	:	03/07/2019

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