Provider Demographics
NPI:1093904054
Name:DORRINGTON MEDICAL ASSOCIATES, PA
Entity Type:Organization
Organization Name:DORRINGTON MEDICAL ASSOCIATES, PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:
Authorized Official - Last Name:VARON
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:713-669-1670
Mailing Address - Street 1:2219 DORRINGTON ST
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77030-3209
Mailing Address - Country:US
Mailing Address - Phone:713-669-1670
Mailing Address - Fax:713-669-1671
Practice Address - Street 1:1302 WAUGH DR # 484
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77019-3908
Practice Address - Country:US
Practice Address - Phone:713-443-1930
Practice Address - Fax:713-529-6880
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-16
Last Update Date:2007-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXJ5933207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX00273UMedicare PIN