Provider Demographics
NPI:1992726681
Name:BANDY, DONALD PAUL (DDS)
Entity type:Individual
Prefix:DR
First Name:DONALD
Middle Name:PAUL
Last Name:BANDY
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4127 DAY DR
Mailing Address - Street 2:
Mailing Address - City:SAN MARCOS
Mailing Address - State:TX
Mailing Address - Zip Code:78666-9540
Mailing Address - Country:US
Mailing Address - Phone:512-396-8488
Mailing Address - Fax:512-396-8699
Practice Address - Street 1:4127 DAY DR.
Practice Address - Street 2:
Practice Address - City:SAN MARCOS
Practice Address - State:TX
Practice Address - Zip Code:78666-9540
Practice Address - Country:US
Practice Address - Phone:512-396-8488
Practice Address - Fax:512-396-8699
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-21
Last Update Date:2010-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX134321223S0112X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXU50741Medicare UPIN