Provider Demographics
NPI:1225132277
Name:NEWSOME, DONNA ELLEN (MD)
Entity type:Individual
Prefix:
First Name:DONNA
Middle Name:ELLEN
Last Name:NEWSOME
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7203 CANA
Mailing Address - Street 2:
Mailing Address - City:GRAND PRAIRIE
Mailing Address - State:TX
Mailing Address - Zip Code:75054-6860
Mailing Address - Country:US
Mailing Address - Phone:817-707-9668
Mailing Address - Fax:817-764-5003
Practice Address - Street 1:7203 CANA
Practice Address - Street 2:
Practice Address - City:GRAND PRAIRIE
Practice Address - State:TX
Practice Address - Zip Code:75054-6860
Practice Address - Country:US
Practice Address - Phone:817-707-9668
Practice Address - Fax:817-764-5003
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-12
Last Update Date:2025-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO20240370762084N0400X
MEMD250422084N0400X
FLME1693912084N0400X
IN01094064A2084N0400X
TN720262084N0400X
TXL34122084N0400X
VA01012827382084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology