Provider Demographics
NPI:1417941758
Name:DOBBS, ALAN KEITH (NP)
Entity Type:Individual
Prefix:MR
First Name:ALAN
Middle Name:KEITH
Last Name:DOBBS
Suffix:
Gender:M
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5920 SARATOGA BLVD STE 610
Mailing Address - Street 2:
Mailing Address - City:CORPUS CHRISTI
Mailing Address - State:TX
Mailing Address - Zip Code:78414-4106
Mailing Address - Country:US
Mailing Address - Phone:361-985-9850
Mailing Address - Fax:361-985-9853
Practice Address - Street 1:5920 SARATOGA BLVD STE 610
Practice Address - Street 2:
Practice Address - City:CORPUS CHRISTI
Practice Address - State:TX
Practice Address - Zip Code:78414-4106
Practice Address - Country:US
Practice Address - Phone:361-985-9850
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-09-01
Last Update Date:2011-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX629988363LF0000X, 363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
1417941758OtherTRICARE SOUTH
TX844N63OtherBCBS-TX
TNPENDINGMedicaid
VA010242207Medicaid
TN103I086169Medicare UPIN
VA010242207Medicaid
TN3907866Medicare UPIN
TXTXB128313Medicare PIN
TX844N63OtherBCBS-TX