Dory, Laurie Boquet

Dory, Laurie Boquet is an sole proprietor health care provider with primary practice located at 901 Travis Ave , Fort Worth TX 76104-3137. She recently has only one registered license in Other Service Providers / Specialist, which is considered as her primary health care specialty. Dory, Laurie Boquet can be contacted via phone (817) 332-5585.

Contact Information

Primary practice address
901 Travis Ave Fort Worth TX 76104-3137
Phone: (817) 332-5585
Fax: (817) 332-5377
Website:
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Health care specialties

SpecialtyCodeLicense #State
Other Service Providers / Specialist 174400000X J4779 Texas

Profile Details

NPI number 1417930900
LBN Legal business name Dory, Laurie Boquet
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Nov 29th, 2005
Last updated Jul 28th, 2008 - about 18 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1417930900 NPPES
Texas Other 3378225 BCBS BLUE LINK NUMBER
Texas MEDICAID 146028901 BCBS BLUE LINK NUMBER
Texas Other 0076EQ BCBS BLUE LINK NUMBER
Texas Other 7540001 BCBS BLUE LINK NUMBER

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