Alexander Dougherty, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

36743 Issued in TX

Practice address

1711 S Colorado St Ste D
Lockhart, TX 78644-4616

Phone

(713) 791-1414

NPI assigned

May 15, 2020

Last updated

May 18, 2021By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Alex Dougherty DDS PLLC

  • Dental Clinic/Center
  • College Station, TX
  • NPI 1295620698
  NPD Authorized official

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

{
    "created_epoch": "1589500800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1621296000000",
    "number": "1457973174",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4522 ROUNDHILL RD",
            "city": "ALEXANDRIA",
            "state": "VA",
            "postal_code": "223102946",
            "telephone_number": "703-835-1821"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1711 S COLORADO ST STE D",
            "city": "LOCKHART",
            "state": "TX",
            "postal_code": "786444616",
            "telephone_number": "713-791-1414"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DOUGHERTY",
        "first_name": "ALEXANDER",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-05-15",
        "last_updated": "2021-05-18",
        "certification_date": "2021-05-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "TX",
            "license": "36743",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Carol Arlene Dettmann, RN, MSN, FNP
• Dewitt Medical District (Chisolm Trail Nursing and Rehabilitation Center)
• Diversicare Chisolm, LLC (Chisolm Trail Nursing & Rehab Center)
• Diversicare Leasing Corp. (Chisolm Trail Nursing & Rehabilitation Center)
• Haley Dawn Dorsett, FNP-C
• Sherrel Downes, FNP-C
• Sarah Catherine Drake, R.D.
• Melissa Dunbar
• Educare Community Living Limited Partnership
• Michael Evan Enriquez, FNP-BC

• General Practice Dentistry in Lockhart, TX
• Providers in Lockhart, TX by specialty
• General Practice Dentistry in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 18, 2021; 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.