Gwendolyn Marie Dubose, P.A.

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA05851 Issued in TX

Practice address

114 W Buffington Ave Ste B
Anderson, TX 77830-4979

Phone

(936) 261-7768

Fax

(936) 249-9932

NPI assigned

Feb 17, 2012

Last updated

Sep 2, 2025By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in TX

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

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.

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• Memorial Hermann Medical Group

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  • NPI 1003985102
  NPD (past)

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

{
    "created_epoch": "1329436800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1756771200000",
    "number": "1467725630",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "114 W BUFFINGTON AVE STE B",
            "city": "ANDERSON",
            "state": "TX",
            "postal_code": "778304979",
            "telephone_number": "936-261-7768",
            "fax_number": "936-249-9932"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "114 W BUFFINGTON AVE STE B",
            "city": "ANDERSON",
            "state": "TX",
            "postal_code": "778304979",
            "telephone_number": "936-261-7768",
            "fax_number": "936-249-9932"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DUBOSE",
        "first_name": "GWENDOLYN",
        "middle_name": "MARIE",
        "name_prefix": "Mrs.",
        "credential": "P.A.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-02-17",
        "last_updated": "2025-09-02",
        "certification_date": "2025-09-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TX",
            "license": "PA05851",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Anderson-Shiro Cisd
• Lisa Evans
• Summer Bartolome Gainey, PH.D., BCBA-D
• Christian Kelarek
• Laura Jean McAuliffe, RNFA
• Mynewcpap, Inc

• Physician Assistant in Anderson, TX
• Providers in Anderson, TX by specialty
• Physician Assistant in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 2, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.