Provider Demographics
NPI:1518779735
Name:DORIA, RICHARD JOSEPHUS
Entity type:Individual
Prefix:
First Name:RICHARD
Middle Name:JOSEPHUS
Last Name:DORIA
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9107 YEARLING ST
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78254-2249
Mailing Address - Country:US
Mailing Address - Phone:210-663-7186
Mailing Address - Fax:
Practice Address - Street 1:9107 YEARLING ST
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78254-2249
Practice Address - Country:US
Practice Address - Phone:210-663-7186
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-01-24
Last Update Date:2025-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1188513363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care