Provider Demographics
NPI:1376512004
Name:DOTT, JEU B JR (MD)
Entity Type:Individual
Prefix:
First Name:JEU
Middle Name:B
Last Name:DOTT
Suffix:JR
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8700 REDWOOD ST
Mailing Address - Street 2:
Mailing Address - City:COLLEGE STATION
Mailing Address - State:TX
Mailing Address - Zip Code:77845-5579
Mailing Address - Country:US
Mailing Address - Phone:979-693-7167
Mailing Address - Fax:979-696-7111
Practice Address - Street 1:8700 REDWOOD ST
Practice Address - Street 2:
Practice Address - City:COLLEGE STATION
Practice Address - State:TX
Practice Address - Zip Code:77845-5579
Practice Address - Country:US
Practice Address - Phone:979-693-7167
Practice Address - Fax:979-696-7111
Is Sole Proprietor?:Yes
Enumeration Date:2006-03-15
Last Update Date:2015-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXF6583207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX103799603Medicaid
TX103799603Medicaid
TX00544VMedicare ID - Type Unspecified