Provider Demographics
NPI:1154575918
Name:DU BOIS, MONICA BEATRICE (PA-C)
Entity type:Individual
Prefix:
First Name:MONICA
Middle Name:BEATRICE
Last Name:DU BOIS
Suffix:
Gender:F
Credentials:PA-C
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Other - Credentials:
Mailing Address - Street 1:3551 ROGER BROOKE DR
Mailing Address - Street 2:CARDIOLOGY SERVICE, BROOKE ARMY MEDICAL CENTER
Mailing Address - City:FT SAM HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:78234
Mailing Address - Country:US
Mailing Address - Phone:210-916-0935
Mailing Address - Fax:210-916-5031
Practice Address - Street 1:3551 ROGER BROOKE DR
Practice Address - Street 2:BROOKE ARMY MEDICAL CENTER
Practice Address - City:FORT SAM HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:78234-4504
Practice Address - Country:US
Practice Address - Phone:210-916-0935
Practice Address - Fax:210-916-3051
Is Sole Proprietor?:No
Enumeration Date:2008-11-06
Last Update Date:2012-12-13
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Provider Licenses
StateLicense IDTaxonomies
TXPA05911363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant