Provider Demographics
NPI:1063516300
Name:DOAN, ROBERT H JR (FNP)
Entity type:Individual
Prefix:
First Name:ROBERT
Middle Name:H
Last Name:DOAN
Suffix:JR
Gender:M
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1702 E DENMAN AVE
Mailing Address - Street 2:
Mailing Address - City:LUFKIN
Mailing Address - State:TX
Mailing Address - Zip Code:75901-6110
Mailing Address - Country:US
Mailing Address - Phone:936-639-1224
Mailing Address - Fax:936-632-0322
Practice Address - Street 1:1702 E DENMAN AVE
Practice Address - Street 2:
Practice Address - City:LUFKIN
Practice Address - State:TX
Practice Address - Zip Code:75901-6110
Practice Address - Country:US
Practice Address - Phone:936-639-1224
Practice Address - Fax:936-639-1224
Is Sole Proprietor?:No
Enumeration Date:2006-09-08
Last Update Date:2017-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP106364363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
NM81482558Medicaid
NM81482558Medicaid