Individual
DORSEY SHANTEL COFFEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
L.S.A.
Contact information
Practice address
7200 FLYNN CIR, AUSTIN, TX 78736-3053
(512) 771-8731
(512) 288-9858
Mailing address
7200 FLYNN CIR, AUSTIN, TX 78736-3053
(512) 771-8731
(512) 288-9858
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
SA00060
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0007LF
BCBS
TX
01
—
SA00060
STATE LICENSE NUMBER
TX
Enumeration date
08/20/2006
Last updated
07/08/2007
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