Individual provider Active NPI

Monica Beatrice Du Bois, PA-C

  • Physician Assistant
  • Fort Sam Houston, TX
National Provider Identifier
1154575918
Registry record updated Dec 13, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA05911 Issued in TX
Practice address
3551 Roger Brooke Dr
Brooke Army Medical Center
Fort Sam Houston, TX 78234-4504
Phone
(210) 916-0935
Fax
(210) 916-3051
NPI assigned
Nov 6, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 13, 2012

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA05911 TX Primary

Addresses

Primary practice location

3551 Roger Brooke Dr
Brooke Army Medical Center
Fort Sam Houston, TX 78234-4504

Mailing address

3551 Roger Brooke Dr
Cardiology Service, Brooke Army Medical Center
Ft Sam Houston, TX 78234
Phone (210) 916-0935

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1225929600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1355356800000",
    "number": "1154575918",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3551 ROGER BROOKE DR",
            "address_2": "CARDIOLOGY SERVICE, BROOKE ARMY MEDICAL CENTER",
            "city": "FT SAM HOUSTON",
            "state": "TX",
            "postal_code": "78234",
            "telephone_number": "210-916-0935",
            "fax_number": "210-916-5031"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3551 ROGER BROOKE DR",
            "address_2": "BROOKE ARMY MEDICAL CENTER",
            "city": "FORT SAM HOUSTON",
            "state": "TX",
            "postal_code": "782344504",
            "telephone_number": "210-916-0935",
            "fax_number": "210-916-3051"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DU BOIS",
        "first_name": "MONICA",
        "middle_name": "BEATRICE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-11-06",
        "last_updated": "2012-12-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TX",
            "license": "PA05911",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Sam Houston, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 13, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.