Provider Demographics
NPI:1588774400
Name:MCDONALD, DAVID KENNETH (MD)
Entity type:Individual
Prefix:
First Name:DAVID
Middle Name:KENNETH
Last Name:MCDONALD
Suffix:
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 1:3325 PLAINVIEW
Mailing Address - Street 2:SUITE 10
Mailing Address - City:PASADENTA
Mailing Address - State:TX
Mailing Address - Zip Code:77504-1923
Mailing Address - Country:US
Mailing Address - Phone:713-943-1090
Mailing Address - Fax:713-941-2079
Practice Address - Street 1:3325 PLAINVIEW
Practice Address - Street 2:SUITE 10
Practice Address - City:PASADENTA
Practice Address - State:TX
Practice Address - Zip Code:77504-1923
Practice Address - Country:US
Practice Address - Phone:713-943-1090
Practice Address - Fax:713-941-2079
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-30
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXE7666207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXL0030925OtherDPS
AM7600415OtherDEA
TXL0030925OtherDPS
00CE32Medicare ID - Type Unspecified