Individual
TEENA TAMBUNGA DOTSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
35 E 31ST ST, SAN ANGELO, TX 76903-2207
(325) 658-5339
(325) 659-8695
Mailing address
2029 W BEAUREGARD AVE, SAN ANGELO, TX 76901-3812
(325) 658-5339
(325) 947-0101
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
PA02850
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
111604802
—
TX
Enumeration date
10/07/2005
Last updated
01/11/2018
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