Provider Demographics
NPI:1285927269
Name:WOOLFOLK, DANEEQUE J (MD)
Entity type:Individual
Prefix:DR
First Name:DANEEQUE
Middle Name:J
Last Name:WOOLFOLK
Suffix:
Gender:
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4520 N MACARTHUR BLVD STE 100
Mailing Address - Street 2:
Mailing Address - City:IRVING
Mailing Address - State:TX
Mailing Address - Zip Code:75038-1235
Mailing Address - Country:US
Mailing Address - Phone:214-630-5256
Mailing Address - Fax:
Practice Address - Street 1:4520 N MACARTHUR BLVD STE 100
Practice Address - Street 2:
Practice Address - City:IRVING
Practice Address - State:TX
Practice Address - Zip Code:75038-1235
Practice Address - Country:US
Practice Address - Phone:214-630-5256
Practice Address - Fax:214-630-2251
Is Sole Proprietor?:No
Enumeration Date:2011-05-24
Last Update Date:2025-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXQ3314207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology