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1386751378

NPI Code Detail

MEDICARE: SUE DOTY MD

MEDICARE: SUE DOTY MD

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
1	207V00000X	Obstetrics & Gynecology Physician	H0306	TX
2	207Q00000X	Family Medicine Physician	H0306	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	129058704	OTHER	TX	CSN
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	826203	OTHER	TX	BCBS

General Provider Information

NPI Number	:	1386751378
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SUE DOTY MD

Provider Business Mailing Address
First Line	:	PO BOX 734812
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75373-4812
Country	:	US
Telephone Number	:	210-358-9500
Fax Number	:	210-358-9183

Provider Business Practice Location Address
First Line	:	200 N COMAL
Second Line	:
City	:	SAN ANTONIO
State	:	TX
Zip	:	78207-3505
Country	:	US
Telephone Number	:	210-335-6260
Fax Number	:	210-358-9183

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/24/2006
Last Update Date	:	01/28/2021

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Directions to “ SUE DOTY MD” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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