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Individual

MRS. MARY VIRGINIA DOUPHRATE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
WHCNP

Contact information

Practice address
802 HOPKINS DRIVE, GARLAND, TX 75040
(214) 266-0780
(214) 266-0784
Mailing address
604 STONEBRIDGE DRIVE, ROCKWALL, TX 75087-3410
(972) 772-5107

Taxonomy

Speciality
Code
Description
License number
State
363LW0102X
Women's Health Nurse Practitioner
Primary
516122
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
516122
BOARD NS EXAMINERS LICENS
TX
Enumeration date
10/03/2006
Last updated
07/08/2007
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