Provider Demographics
NPI:1225095953
Name:WALL, DONNA A (MD)
Entity Type:Individual
Prefix:DR
First Name:DONNA
Middle Name:A
Last Name:WALL
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Gender:F
Credentials:MD
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Mailing Address - Street 1:7711 LOUIS PASTEUR DR
Mailing Address - Street 2:707
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78229-3415
Mailing Address - Country:US
Mailing Address - Phone:210-575-8500
Mailing Address - Fax:210-575-8506
Practice Address - Street 1:7700 FLOYD CURL
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78229-3979
Practice Address - Country:US
Practice Address - Phone:210-575-7138
Practice Address - Fax:210-575-6373
Is Sole Proprietor?:No
Enumeration Date:2006-04-27
Last Update Date:2007-12-03
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Provider Licenses
StateLicense IDTaxonomies
TXL20482080P0207X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0207XAllopathic & Osteopathic PhysiciansPediatricsPediatric Hematology-Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX8585J5OtherMEDICARE NUMBER