Provider Demographics
NPI:1730560657
Name:DONOHUE, DANIEL KEITH (CSFA, CST)
Entity type:Individual
Prefix:MR
First Name:DANIEL
Middle Name:KEITH
Last Name:DONOHUE
Suffix:
Gender:M
Credentials:CSFA, CST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16506 PEMBRANCH
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78240-5615
Mailing Address - Country:US
Mailing Address - Phone:210-685-0743
Mailing Address - Fax:
Practice Address - Street 1:16506 PEMBRANCH
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78240-5615
Practice Address - Country:US
Practice Address - Phone:210-685-0743
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-06-16
Last Update Date:2015-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246ZC0007XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherSurgical Assistant