Provider Demographics
NPI:1073597464
Name:PERSAUD, DONNA I (MD)
Entity Type:Individual
Prefix:DR
First Name:DONNA
Middle Name:I
Last Name:PERSAUD
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 660599
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75266-0599
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:802 HOPKINS ST
Practice Address - Street 2:GARLAND HEALTH CENTER
Practice Address - City:GARLAND
Practice Address - State:TX
Practice Address - Zip Code:75040-7379
Practice Address - Country:US
Practice Address - Phone:214-266-0700
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-11-30
Last Update Date:2012-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXJ0628208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX136043015Medicaid
TX8J3492OtherBLUE CROSS BLUE SHIELD
TX136043010Medicaid
TX136043009Medicaid
TX136043008Medicaid
TX136043016Medicaid
TX136043017Medicaid
TX136043019Medicaid
TX136043014Medicaid
TX136043011Medicaid
TX136043012Medicaid
TX136043018Medicaid
TX136043008Medicaid
TXE94572Medicare UPIN