Individual
MR. DOUGLAS IVAN DUSENBERRY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
3551 ROGER BROOKE DR, JBSA FT SAM HOUSTON, TX 78234-4504
(210) 916-5666
Mailing address
3851 ROGER BROOKE DR, BROOKE ARMY MEDICAL CENTER, FORT SAM HOUSTON, TX 78234-4501
(210) 916-0517
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
PA04877
TX
Other
Enumeration date
01/10/2006
Last updated
08/16/2021
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