Provider Demographics
NPI:1124025036
Name:MACDONALD, STEVEN R (MD)
Entity Type:Individual
Prefix:
First Name:STEVEN
Middle Name:R
Last Name:MACDONALD
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 1:6124 W PARKER RD
Mailing Address - Street 2:SUITE 134
Mailing Address - City:PLANO
Mailing Address - State:TX
Mailing Address - Zip Code:75093-8122
Mailing Address - Country:US
Mailing Address - Phone:972-981-7777
Mailing Address - Fax:972-981-7750
Practice Address - Street 1:6124 W PARKER RD
Practice Address - Street 2:SUITE 134
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75093-8122
Practice Address - Country:US
Practice Address - Phone:972-981-7777
Practice Address - Fax:972-981-7750
Is Sole Proprietor?:Yes
Enumeration Date:2005-07-07
Last Update Date:2011-10-20
Deactivation Date:2006-05-19
Deactivation Code:
Reactivation Date:2006-06-01
Provider Licenses
StateLicense IDTaxonomies
TXK8313207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXG88742Medicare UPIN
TXTXB101744Medicare PIN