Provider Demographics
NPI:1902949001
Name:MCKINLEY, DONALD (DC)
Entity type:Individual
Prefix:DR
First Name:DONALD
Middle Name:
Last Name:MCKINLEY
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:26865 INTERSTATE 45 STE 300
Mailing Address - Street 2:
Mailing Address - City:THE WOODLANDS
Mailing Address - State:TX
Mailing Address - Zip Code:77380-4046
Mailing Address - Country:US
Mailing Address - Phone:512-326-1400
Mailing Address - Fax:512-326-1463
Practice Address - Street 1:2500 W WILLIAM CANNON DR STE 704
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78745-5252
Practice Address - Country:US
Practice Address - Phone:512-326-1400
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-02-15
Last Update Date:2024-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXDC6885111N00000X, 111NN1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
No111NN1001XChiropractic ProvidersChiropractorNutrition
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX8K8520OtherBCBS
TXDC6885OtherTEXAS LICENSE
TX32-0096752OtherTAX ID
TX32-0096752OtherTAX ID
TXU59572Medicare UPIN