Black, Dorris Bethany
Black, Dorris Bethany is an individual health care provider with primary practice located at 1905 Sw Hk Dodgen Loop , Temple TX 76502-3498. She recently has only one registered license in Allopathic & Osteopathic Physicians / Pediatrics, which is considered as her primary health care specialty. Black, Dorris Bethany can be contacted via phone (254) 298-2400.Contact Information
Primary practice address
1905 Sw Hk Dodgen Loop
Temple TX 76502-3498
Phone: (254) 298-2400
Fax: (254) 778-7197
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Pediatrics | 208000000X | H3548 | Texas |
Profile Details
| NPI number | 1548220718 |
|---|---|
| LBN Legal business name | Black, Dorris Bethany |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Mar 23rd, 2006 |
| Last updated | Oct 1st, 2012 - about 12 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1548220718 | NPPES |
| Other | 8AA947 | BLUE SHIELD |
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