Dora A. Fast, FNP
Individual provider Active NPI Family Nurse Practitioner · Cotulla, TX
NPI 1053733014 · NPPES record last updated Jan 10, 2014
Key facts
- NPI
- 1053733014
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Nurse Practitioner 363LF0000X
- License
- 738349 (TX)
- Practice address
- 105 S. Stewart St.
Cotulla, TX 78014 - Phone
- (830) 879-3047
- NPI assigned
- Jan 10, 2014
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 2
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in TX
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20170807002621 | TX | Order and Referring Only - Nurse Practitioner | 4688722887 |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 738349 | TX | MD | Family Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| South Texas Rural Health Services, Inc. | Family | Past | Accepting new patients |
| South Texas Rural Health Services Inc | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | 738349 | TX | Yes |
Addresses
Primary practice location
105 S. Stewart St.
Cotulla, TX 78014
Mailing address
605 Leona
Cotulla, TX 78014
Phone (830) 879-2256
Other providers in Cotulla, TX
- Cotulla Isd
- Cotulla Smiles PLLC
- County of la Salle
- County of la Salle
- County of la Salle
- Araceli M Flores
- Frank and Brenda Jennings Dba Cotulla EMS
- Gaddis Pharmacy LC
- Jesus Garcia
- Ma Angela S Garner
All providers in Cotulla, TX · Family Nurse Practitioner in Texas
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 10, 2014. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.