Individual
DR. JONATHAN J DORA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
6560 FANNIN ST, SUITE 760, HOUSTON, TX 77030-2761
(713) 790-0024
(713) 790-9767
Mailing address
PO BOX 540363, HOUSTON, TX 77254-0363
(713) 790-0024
(713) 790-9767
Taxonomy
Speciality
Code
Description
License number
State
208200000X
Plastic Surgery Physician
Primary
D4977
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
741949173
TAX IDENTIFICATION NUMBER
TX
01
—
D4977
LICENSE NUMBER
TX
Enumeration date
11/29/2006
Last updated
07/17/2019
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