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General NPI Number Information
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NPI Number | 1053561761
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Entity Type | Organization
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Legal Business Name | ROBERT JAMES DOUGHERTY MD PLLC
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Dates
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Enumeration Date | 09/30/2008
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Last Update Date | 11/17/2025
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Provider Practice Location Address
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Address Line | 623 HIGHWAY 71 W STE 204
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City | BASTROP
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State | TX
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Zip | 78602-4166
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Country | US
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Telephone | 512-581-5016
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Fax | 512-985-5987
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Provider Business Mailing Address
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Address Line | 623 HIGHWAY 71 W STE 204
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City | BASTROP
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State | TX
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Zip | 78602-4166
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Country | US
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Telephone | 512-581-5016
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Fax | 512-985-5987
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Authorized Official
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Title or Position | PRESIDENT
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Name | ROBERT DOUGHERTY
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Credential | MD
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Telephone | 512-581-5016
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | L2226
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License Number State | TX
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