Healthcare Provider Details

I. General information

NPI: 1043466873
Provider Name (Legal Business Name): DOROTHY MAY WATSON MSN, APRN, FNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/12/2008
Last Update Date: 04/09/2020
Certification Date: 04/09/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3944 RR 620 S STE 102
BEE CAVE TX
78738-7178
US

IV. Provider business mailing address

13830 SAWYER RANCH RD STE 102
DRIPPING SPRINGS TX
78620-5514
US

V. Phone/Fax

Practice location:
  • Phone: 512-777-0884
  • Fax: 512-777-0933
Mailing address:
  • Phone: 512-301-6400
  • Fax: 512-301-6401

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number22434.0967
License Number StateWY
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number697918
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: