Provider Demographics
NPI:1265431472
Name:FUENTES, DOROTHY E (MD)
Entity type:Individual
Prefix:DR
First Name:DOROTHY
Middle Name:E
Last Name:FUENTES
Suffix:
Gender:F
Credentials:MD
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Other - Credentials:
Mailing Address - Street 1:3533 S ALAMEDA ST
Mailing Address - Street 2:SUITE #303, JOESPH M. SLOAN MEDICAL BLDG.
Mailing Address - City:CORPUS CHRISTI
Mailing Address - State:TX
Mailing Address - Zip Code:78411-1721
Mailing Address - Country:US
Mailing Address - Phone:361-853-3222
Mailing Address - Fax:361-853-7311
Practice Address - Street 1:3533 S ALAMEDA ST
Practice Address - Street 2:SUITE #303, JOESPH M. SLOAN MEDICAL BLDG.
Practice Address - City:CORPUS CHRISTI
Practice Address - State:TX
Practice Address - Zip Code:78411-1721
Practice Address - Country:US
Practice Address - Phone:361-853-3222
Practice Address - Fax:361-561-2692
Is Sole Proprietor?:No
Enumeration Date:2005-07-19
Last Update Date:2018-10-24
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Provider Licenses
StateLicense IDTaxonomies
TXK8159208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX8D3727Medicare PIN
TXI26644Medicare UPIN