Provider Demographics
NPI:1205822061
Name:QUIGLEY, DANIEL D (MD)
Entity Type:Individual
Prefix:DR
First Name:DANIEL
Middle Name:D
Last Name:QUIGLEY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:1500 UNIVERSITY DR E
Mailing Address - Street 2:SUITE 100
Mailing Address - City:COLLEGE STATION
Mailing Address - State:TX
Mailing Address - Zip Code:77840-2600
Mailing Address - Country:US
Mailing Address - Phone:979-846-1100
Mailing Address - Fax:979-260-9390
Practice Address - Street 1:3370 S TEXAS AVE
Practice Address - Street 2:SUITE B
Practice Address - City:BRYAN
Practice Address - State:TX
Practice Address - Zip Code:77802-3127
Practice Address - Country:US
Practice Address - Phone:979-595-1700
Practice Address - Fax:979-595-1740
Is Sole Proprietor?:No
Enumeration Date:2005-09-26
Last Update Date:2012-07-24
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
TXK3933208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX154467801Medicaid
TX1821185299OtherNPI AGENCY
TX000951608Medicaid
TX154467803Medicaid
TX000951607Medicaid
TX1649265646OtherNPI CLINIC B
TX741715140OtherTAX ID
TX185649401Medicaid
TX1649265646OtherNPI CLINIC B
TX185649401Medicaid
TX451986Medicare Oscar/Certification
TX000951607Medicaid
TX671848Medicare Oscar/Certification