MEDICARE: DR. DAVID ERIC DORSEY O.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	152W00000X	Optometrist	3625TG	TX

General Provider Information

NPI Number	:	1922134733
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DAVID ERIC DORSEY O.D.

Provider Business Mailing Address
First Line	:	1302 S GEN MCMULLEN DR
Second Line	:	STE. 100
City	:	SAN ANTONIO
State	:	TX
Zip	:	78237-4200
Country	:	US
Telephone Number	:	210-434-1470
Fax Number	:	210-434-1001

Provider Business Practice Location Address
First Line	:	1302 S GEN MCMULLEN DR
Second Line	:	100
City	:	SAN ANTONIO
State	:	TX
Zip	:	78237-4200
Country	:	US
Telephone Number	:	210-434-1470
Fax Number	:	210-434-1001

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

Provider Enumeration Date	:	02/26/2007
Last Update Date	:	12/05/2013

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