Provider Demographics
NPI:1689021917
Name:DOCTORS EXTENDERS, INC
Entity Type:Organization
Organization Name:DOCTORS EXTENDERS, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/ DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:BRIAN
Authorized Official - Middle Name:SCOTT
Authorized Official - Last Name:MORROW
Authorized Official - Suffix:
Authorized Official - Credentials:ANP
Authorized Official - Phone:214-389-0855
Mailing Address - Street 1:1104 MONTERREY ST
Mailing Address - Street 2:
Mailing Address - City:BEDFORD
Mailing Address - State:TX
Mailing Address - Zip Code:76022-7531
Mailing Address - Country:US
Mailing Address - Phone:214-389-0855
Mailing Address - Fax:214-389-0859
Practice Address - Street 1:1104 MONTERREY ST
Practice Address - Street 2:
Practice Address - City:BEDFORD
Practice Address - State:TX
Practice Address - Zip Code:76022-7531
Practice Address - Country:US
Practice Address - Phone:214-389-0855
Practice Address - Fax:214-389-0859
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-05-17
Last Update Date:2016-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP115380363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGroup - Multi-Specialty