Provider Demographics
NPI:1578535787
Name:VAN DORFY, AMY E (MD)
Entity Type:Individual
Prefix:DR
First Name:AMY
Middle Name:E
Last Name:VAN DORFY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:AMY
Other - Middle Name:E
Other - Last Name:BURNS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:608 GATEWAY CENTRAL
Mailing Address - Street 2:SUITE 100
Mailing Address - City:MARBLE FALLS
Mailing Address - State:TX
Mailing Address - Zip Code:78654-6354
Mailing Address - Country:US
Mailing Address - Phone:830-693-2005
Mailing Address - Fax:830-798-2006
Practice Address - Street 1:608 GATEWAY CENTRAL
Practice Address - Street 2:SUITE 100
Practice Address - City:MARBLE FALLS
Practice Address - State:TX
Practice Address - Zip Code:78654-6354
Practice Address - Country:US
Practice Address - Phone:830-693-2005
Practice Address - Fax:830-798-2006
Is Sole Proprietor?:No
Enumeration Date:2006-02-02
Last Update Date:2016-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXL4778207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX8F1570Medicare PIN
H69298Medicare UPIN