Healthcare Provider Details

I. General information

NPI: 1235355587
Provider Name (Legal Business Name): RICHARD ELDON DUEY MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/17/2007
Last Update Date: 11/06/2025
Certification Date: 11/06/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

110 E BANDERA RD
BOERNE TX
78006-2802
US

IV. Provider business mailing address

PO BOX 2146
SAN ANTONIO TX
78297-2146
US

V. Phone/Fax

Practice location:
  • Phone: 210-481-1700
  • Fax: 210-481-1705
Mailing address:
  • Phone: 210-481-1700
  • Fax: 210-481-1705

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207XP3100X
TaxonomyPediatric Orthopaedic Surgery Physician
License NumberN9540
License Number StateTX
# 2
Primary TaxonomyY
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License NumberN9540
License Number StateTX
# 3
Primary TaxonomyN
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License Number6412
License Number StateKS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: