Individual
MARY C DUBOSE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
505 S JOHN REDDITT DR, LUFKIN, TX 75904-3120
(936) 639-3036
(936) 639-3064
Mailing address
2 MEDICAL CENTER BLVD, LUFKIN, TX 75904-3175
(936) 634-8434
(936) 639-2581
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
AP102594
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
088573301
—
TX
01
—
513353
LICENSE
TX
Enumeration date
10/21/2005
Last updated
02/04/2025
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