Provider Demographics
NPI:1215944780
Name:MCDONALD, JOSEPH DAMIAN (MD)
Entity type:Individual
Prefix:
First Name:JOSEPH
Middle Name:DAMIAN
Last Name:MCDONALD
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1801 S 5TH ST
Mailing Address - Street 2:STE 114
Mailing Address - City:MCALLEN
Mailing Address - State:TX
Mailing Address - Zip Code:78503-2927
Mailing Address - Country:US
Mailing Address - Phone:956-682-6346
Mailing Address - Fax:956-618-1199
Practice Address - Street 1:1801 S 5TH ST
Practice Address - Street 2:STE 114
Practice Address - City:MCALLEN
Practice Address - State:TX
Practice Address - Zip Code:78503-2927
Practice Address - Country:US
Practice Address - Phone:956-682-6346
Practice Address - Fax:956-618-1199
Is Sole Proprietor?:No
Enumeration Date:2006-08-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXE1672208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
C19127Medicare UPIN
C19127Medicare ID - Type Unspecified