Provider Demographics
NPI:1366424673
Name:LITTLE, DONALD G (MD)
Entity type:Individual
Prefix:DR
First Name:DONALD
Middle Name:G
Last Name:LITTLE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:6300 LA CALMA DR
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78752-3843
Mailing Address - Country:US
Mailing Address - Phone:888-800-8236
Mailing Address - Fax:512-685-0612
Practice Address - Street 1:100 W CROSS ST
Practice Address - Street 2:
Practice Address - City:MADISONVILLE
Practice Address - State:TX
Practice Address - Zip Code:77864-2432
Practice Address - Country:US
Practice Address - Phone:936-348-2631
Practice Address - Fax:936-348-3404
Is Sole Proprietor?:No
Enumeration Date:2005-11-14
Last Update Date:2013-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXM8796207P00000X
IA33005207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA02091OtherBX
IA930097244OtherRR MC
IA0189340Medicaid
H00908Medicare UPIN
IA0189340Medicaid