Provider Demographics
NPI:1003009986
Name:VANDONGEN, DANIQUE LYSANNE (MD)
Entity Type:Individual
Prefix:DR
First Name:DANIQUE
Middle Name:LYSANNE
Last Name:VANDONGEN
Suffix:
Gender:F
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:PO BOX 520
Mailing Address - Street 2:
Mailing Address - City:KATY
Mailing Address - State:TX
Mailing Address - Zip Code:77492-0520
Mailing Address - Country:US
Mailing Address - Phone:281-583-6700
Mailing Address - Fax:281-505-3895
Practice Address - Street 1:23331 GRAND RESERVE DR
Practice Address - Street 2:
Practice Address - City:KATY
Practice Address - State:TX
Practice Address - Zip Code:77494-4850
Practice Address - Country:US
Practice Address - Phone:281-505-3500
Practice Address - Fax:281-505-3895
Is Sole Proprietor?:Yes
Enumeration Date:2007-08-23
Last Update Date:2023-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXM6929174400000X, 208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation
No174400000XOther Service ProvidersSpecialist