Provider Demographics
NPI:1164403408
Name:STRAN, DONALD CALVIN (DPM)
Entity Type:Individual
Prefix:DR
First Name:DONALD
Middle Name:CALVIN
Last Name:STRAN
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:121 HIGHWAY 332 W
Mailing Address - Street 2:STE. G
Mailing Address - City:LAKE JACKSON
Mailing Address - State:TX
Mailing Address - Zip Code:77566-4028
Mailing Address - Country:US
Mailing Address - Phone:979-297-8500
Mailing Address - Fax:979-297-6883
Practice Address - Street 1:345 E PARKWOOD AVE
Practice Address - Street 2:
Practice Address - City:FRIENDSWOOD
Practice Address - State:TX
Practice Address - Zip Code:77546-5147
Practice Address - Country:US
Practice Address - Phone:281-992-0006
Practice Address - Fax:281-992-0009
Is Sole Proprietor?:Yes
Enumeration Date:2005-11-11
Last Update Date:2009-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXTX1036213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXF000DX906Medicaid
TX89480YOtherBCBS PROVIDER
TX00DX90OtherBCBS PROVIDER
TX89480YOtherBCBS PROVIDER
TX3956610001Medicare NSC
TX00DX906Medicare PIN
TX00DX90Medicare PIN
TX00DX90OtherBCBS PROVIDER