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General NPI Number Information
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NPI Number | 1386623759
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Entity Type | Individual
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Provider Name | BARBARA DOROTHEA DAUERTY P.A.
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Gender | Female
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Dates
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Enumeration Date | 01/12/2006
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Last Update Date | 09/21/2020
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Provider Practice Location Address
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Address Line | 1116 12TH STREET SUITE # 3
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City | BANDERA
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State | TX
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Zip | 78003
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Country | US
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Telephone | 830-796-3448
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Fax | 830-796-3840
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Provider Business Mailing Address
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Address Line | 130 STATE HIGHWAY 173 N UNIT 519
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City | BANDERA
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State | TX
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Zip | 78003-8025
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Country | US
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Telephone | 830-792-3251
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Fax | 830-796-3840
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363AM0700X
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Taxonomy Name | Medical Physician Assistant
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License Number | 000942
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 363AM0700X
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Taxonomy Name | Medical Physician Assistant
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License Number | PA10003237
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License Number State | WA
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Taxonomy #3
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Taxonomy Code | 363AM0700X
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Taxonomy Name | Medical Physician Assistant
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License Number | PA13239
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License Number State | TX
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