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NPI Code Detail

MEDICARE: DR. DOROTHY E FUENTES M.D.

MEDICARE: DR. DOROTHY E FUENTES M.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1208000000XPediatrics PhysicianK8159TX

General Provider Information

NPI Number : 1265431472
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. DOROTHY E FUENTES M.D.
Provider Business Mailing Address
First Line : 3533 S ALAMEDA ST
Second Line : SUITE #303, JOESPH M. SLOAN MEDICAL BLDG.
City : CORPUS CHRISTI
State : TX
Zip : 78411-1721
Country : US
Telephone Number : 361-853-3222
Fax Number : 361-853-7311
Provider Business Practice Location Address
First Line : 3533 S ALAMEDA ST
Second Line : SUITE #303, JOESPH M. SLOAN MEDICAL BLDG.
City : CORPUS CHRISTI
State : TX
Zip : 78411-1721
Country : US
Telephone Number : 361-853-3222
Fax Number : 361-561-2692
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/19/2005
Last Update Date : 10/24/2018

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