Provider Demographics
NPI:1093790222
Name:WARD, DONALD PATRICK (MD)
Entity Type:Individual
Prefix:
First Name:DONALD
Middle Name:PATRICK
Last Name:WARD
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4007 JAMES CASEY ST
Mailing Address - Street 2:SUITE B220
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78745-3369
Mailing Address - Country:US
Mailing Address - Phone:512-440-1113
Mailing Address - Fax:512-444-1346
Practice Address - Street 1:4007 JAMES CASEY ST
Practice Address - Street 2:SUITE B220
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78745-3369
Practice Address - Country:US
Practice Address - Phone:512-440-1113
Practice Address - Fax:512-444-1346
Is Sole Proprietor?:Yes
Enumeration Date:2005-12-09
Last Update Date:2007-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXF7285174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX00FS39Medicare ID - Type Unspecified
TXC23164Medicare UPIN