Provider Demographics
NPI:1316114952
Name:DONNA M DURAN MD PA
Entity type:Organization
Organization Name:DONNA M DURAN MD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DONNA
Authorized Official - Middle Name:M
Authorized Official - Last Name:DURAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:817-568-2277
Mailing Address - Street 1:11797 SOUTH FWY STE 238
Mailing Address - Street 2:
Mailing Address - City:BURLESON
Mailing Address - State:TX
Mailing Address - Zip Code:76028-7035
Mailing Address - Country:US
Mailing Address - Phone:817-568-2277
Mailing Address - Fax:817-568-2254
Practice Address - Street 1:11797 SOUTH FWY STE 238
Practice Address - Street 2:
Practice Address - City:BURLESON
Practice Address - State:TX
Practice Address - Zip Code:76028-7035
Practice Address - Country:US
Practice Address - Phone:817-568-2277
Practice Address - Fax:817-568-2254
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-05-13
Last Update Date:2021-12-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXJ6413174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty