MEDICARE: DR. DOROTHY F MERRITT 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
1	207Q00000X	Family Medicine Physician	G9878	TX
2	207R00000X	Internal Medicine Physician	G9878	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1881698579
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DOROTHY F MERRITT M.D.

Provider Business Mailing Address
First Line	:	6608 GULF FWY STE 100
Second Line	:
City	:	LA MARQUE
State	:	TX
Zip	:	77568-4095
Country	:	US
Telephone Number	:	409-655-2770
Fax Number	:	844-234-6011

Provider Business Practice Location Address
First Line	:	6608 GULF FWY STE 100
Second Line	:
City	:	LA MARQUE
State	:	TX
Zip	:	77568-4095
Country	:	US
Telephone Number	:	409-655-2770
Fax Number	:	844-234-6011

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

Provider Enumeration Date	:	06/09/2005
Last Update Date	:	06/05/2024

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