Organization
GEORGETOWN PULMONARY ASSOCIATES, P.A.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DOMINIC R DEKERATRY M.D. (PRESIDENT)
(512) 819-0132
Entity
Organization
Contact information
Practice address
1900 SCENIC DRIVE, SUITE 2208, GEORGETOWN, TX 78626-7703
(512) 819-0132
(512) 819-9335
Mailing address
PO BOX 679706, DALLAS, TX 75267-9706
(512) 819-0132
(512) 819-9335
Taxonomy
Speciality
Code
Description
License number
State
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
L0787
TX
207RP1001X
Pulmonary Disease Physician
Primary
L0787
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2064198-01
—
TX
Enumeration date
07/30/2009
Last updated
10/29/2018
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