DR. DORRIS BETHANY BLACK (NPI# 1548220718) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1548220718 |
Entity Type | Individual |
Full Name | DR. DORRIS BETHANY BLACK |
Credential | M.D. |
Practice Address |
1905 Sw Hk Dodgen Loop Temple TX 76502-3498 |
Practice Telephone | 2542982400 |
Practice Fax Number | 2547787197 |
Mailing Telephone | 2542982400 |
Mailing Fax Number | 2547787197 |
Enumeration Date | 2006-03-23 |
Last Update Date | 2012-10-01 |
Gender Code | F |
Is Sole Proprietor | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 208000000X | Pediatrics | H3548 | TX | Allopathic & Osteopathic Physicians |
State | Issuer | Identifier | Type Code |
---|---|---|---|
BLUE SHIELD | 8AA947 | 01 |
Street Address |
1905 SW HK DODGEN LOOP |
City | TEMPLE |
State | TX |
Zip Code | 76502-3498 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1588821540 | Marylynn Ritter | Pathology | 1905 Sw Hk Dodgen Loop, Temple, TX 76502 | 2008-05-19 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1033710850 | Bih Mobanoe Chi | Pharmacist | 6801 West Adams Avenue, Temple, TX 76502 | 2020-11-06 |
1639705403 | Robert David Pompella | Chiropractor | 4805 Stone Ridge Dr, Temple, TX 76502 | 2020-03-12 |
1275167488 | Luong Dental, LLC | Dentist | 5297 S. 31st Street, Ste 111, Temple, TX 76502 | 2020-02-26 |
1093357931 | Ryan T Stephens Dmd Pllc | Dentist | 5408 W. Adams Suite 102, Temple, TX 76502 | 2019-10-11 |
1164071817 | Danyelle Denise Pividori | Licensed Vocational Nurse | 992 Marlandwood Rd, Temple, TX 76502 | 2019-09-05 |
1831670652 | Jane Lida Jarosz | Registered Nurse | 99 Marlandwood, Temple, TX 76502 | 2018-08-29 |
1043791809 | Elsa Gamban Baker | Licensed Practical Nurse | 5711 Hopkins Dr, Temple, TX 76502 | 2018-08-28 |
1659859288 | Laura Bright | Licensed Vocational Nurse | 990 Marlanwood, Temple, TX 76502 | 2018-08-06 |
1811489974 | Rockdale Blackhawk, LLC | Clinic/Center | 1909 Sw Hk Dodgen Loop, Temple, TX 76502 | 2018-06-05 |
1871094573 | Moc Temple, LLC | Skilled Nursing Facility | 725 Marlandwood Rd., Temple, TX 76502 | 2018-02-27 |
Find all providers in zip 76502 |
Taxonomy Code | 208000000X |
Grouping | Allopathic & Osteopathic Physicians |
Classification | Pediatrics |
A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development. |
Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Pediatrics, 2007. http://www.abp.org/. American Osteopathic Board of Pediatrics, 2007. http://www.osteopathic.org/certificatio - Board certification for Medical Doctors (MDs) is provided by the American Board of Pediatrics. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Pediatrics. |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1689102717 | Andrew Duc-tuan Tran | Pediatrics | Ms -ck-300 2401 South 31st St, Temple, TX 76508-0001 | 2017-06-02 |
1790196475 | Cassandra Lefevre | Pediatrics | 5119 April Dawn, Temple, TX 76502-3388 | 2014-05-15 |
1497041511 | Anandita Pal | Pediatrics | 204a Andy Ln, Temple, TX 76502-7707 | 2011-06-27 |
1417170275 | Michael Ross Weir | Pediatrics | 2516 Canyon Creek Dr, Temple, TX 76502-3105 | 2007-04-10 |
1972564706 | Sharyl J. Santema | Pediatrics | 6684 W Adams Ave, Temple, TX 76502-5632 | 2006-03-31 |
1639139041 | David R. Krauss | Pediatrics | 3106 White Oak Dr, Temple, TX 76502-2937 | 2006-03-28 |
1124556204 | Joseph Gregory Wilbanks | Pediatrics | 1901 Sw H K Dodgen Loop, Temple, TX 76502-1814 | 2017-06-01 |
1073040168 | Parneet Dhaliwal | Pediatrics | 2401 South 31st Street, Ms-ck 300, Temple, TX 76508 | 2017-05-19 |
1548797863 | Grace Yu | Pediatrics | 1901 Sw H K Dodgen Loop, Temple, TX 76502-1814 | 2017-05-17 |
1689100711 | Allen Ruan | Pediatrics | 6684 W Adams Ave, Temple, TX 76502-5632 | 2017-05-10 |
Find all providers in TEMPLE |
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Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.