Provider Demographics
NPI:1568453488
Name:DONAHOE, CASHELL JR (MD)
Entity type:Individual
Prefix:
First Name:CASHELL
Middle Name:
Last Name:DONAHOE
Suffix:JR
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 1:117 MEDICAL DR
Mailing Address - Street 2:SUITE #2
Mailing Address - City:VICTORIA
Mailing Address - State:TX
Mailing Address - Zip Code:77904-3113
Mailing Address - Country:US
Mailing Address - Phone:361-573-4331
Mailing Address - Fax:361-573-5096
Practice Address - Street 1:117 MEDICAL DR
Practice Address - Street 2:SUITE #2
Practice Address - City:VICTORIA
Practice Address - State:TX
Practice Address - Zip Code:77904-3102
Practice Address - Country:US
Practice Address - Phone:361-573-4331
Practice Address - Fax:361-573-5096
Is Sole Proprietor?:No
Enumeration Date:2005-10-31
Last Update Date:2008-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXE7893207Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX84K501OtherBCBS PROVIDER #
TX126187701Medicaid
TX4384775OtherAETNA
TXC15316Medicare UPIN
TX126187701Medicaid