Physician Compare National (NPI:1326105511)

HEALTHCARE PROVIDER: NEFERTITI C DUPONT MD

Physician Compare National contains general information about individual eligible professionals (EPs) such as demographic information and Medicare quality program participation.

Individual Professional Information
NPI	1326105511
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	4385724707
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20140905002266
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	DUPONT
	Individual professional last name
Provider First Name	NEFERTITI
	Individual professional first name
Provider Middle Name	C
	Individual professional middle name
Provider Gender	F
	The provider's gender if the provider is a person.

Medical School Information
Medical School Name	TEXAS A & M UNIVERSITY SYSTEM, HSC, COLLEGE OF MEDICINE
	Individual professional's medical school
Graduation Year	1999
	Individual professional's medical school graduation year
Primary Specialty	GYNECOLOGICAL ONCOLOGY
	Primary medical specialty reported by the individual professional in the selected enrollment
Secondary Specialty 1	OBSTETRICS/GYNECOLOGY
	First secondary medical specialty reported by the individual professional in the selected enrollment
All Secondary Specialties	OBSTETRICS/GYNECOLOGY
	All four secondary specialties reported by the individual professional in the selected enrollment, separated by commas

Practice Information
Line 1 Street Address	128 VISION PARK BLVD
	Group Practice or individual's line 1 address
Line 2 Street Address	SUITE 280
	Group Practice or individual's line 2 address
City	SHENANDOAH
	Group Practice or individual's city
State	TX
	Group Practice or individual's state
Zip Code	773843017
	Group Practice or individual's zip code (9 digits when available)

Hospital(s) Affiliation Information
Hospital Affiliation CCN 1	260138
	Medicare CCN of hospital where individual professional provides service 1
Hospital Affiliation LBN 1	ST LUKES HOSPITAL OF KANSAS CITY
	Legal business name of hospital where individual professional provides service 1
Hospital Affiliation CCN 2	670122
	Medicare CCN of hospital where individual professional provides service 2
Hospital Affiliation LBN 2	HOUSTON METHODIST THE WOODLANDS HOSPITAL
	Legal business name of hospital where individual professional provides service 2
Professional Accepts Medicare Assignment	Y