Individual
DORIA LIVING
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PNP
Contact information
Practice address
221 3RD ST W BLDG 1040, JBSA RANDOLPH, TX 78150-4800
(210) 652-8544
Mailing address
221 3RD ST W BLDG 1040, JBSA RANDOLPH, TX 78150-4800
(210) 652-8544
Taxonomy
Speciality
Code
Description
License number
State
163WE0003X
Emergency Registered Nurse
199069
GA
163WN0002X
Neonatal Intensive Care Registered Nurse
199069
GA
208000000X
Pediatrics Physician
1636008
TX
363LP0200X
Pediatric Nurse Practitioner
Primary
1636008
TX
Other
Enumeration date
09/16/2020
Last updated
04/17/2026
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