Provider Demographics
NPI:1740590728
Name:NOBLE W. DOSS, JR. M.D.,P.A.
Entity Type:Organization
Organization Name:NOBLE W. DOSS, JR. M.D.,P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:NOBLE
Authorized Official - Middle Name:WEBSTER
Authorized Official - Last Name:DOSS
Authorized Official - Suffix:JR
Authorized Official - Credentials:MD
Authorized Official - Phone:512-451-7991
Mailing Address - Street 1:4201 MARATHON BLVD
Mailing Address - Street 2:SUITE 301
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78756-3410
Mailing Address - Country:US
Mailing Address - Phone:512-451-7991
Mailing Address - Fax:512-451-1862
Practice Address - Street 1:4201 MARATHON BLVD
Practice Address - Street 2:SUITE 301
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78756-3410
Practice Address - Country:US
Practice Address - Phone:512-451-7991
Practice Address - Fax:512-451-1862
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-10-08
Last Update Date:2010-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXE3629207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX123897405Medicaid