Provider Demographics
NPI:1225132277
Name:NEWSOME, DONNA ELLEN (MD)
Entity Type:Individual
Prefix:
First Name:DONNA
Middle Name:ELLEN
Last Name:NEWSOME
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2364 N. HWY 287
Mailing Address - Street 2:SUITE 119
Mailing Address - City:MANSFIELD
Mailing Address - State:TX
Mailing Address - Zip Code:76063
Mailing Address - Country:US
Mailing Address - Phone:214-556-1595
Mailing Address - Fax:214-556-1645
Practice Address - Street 1:2364 N. HWY 287
Practice Address - Street 2:SUITE 119
Practice Address - City:MANSFIELD
Practice Address - State:TX
Practice Address - Zip Code:76063
Practice Address - Country:US
Practice Address - Phone:214-556-1595
Practice Address - Fax:214-556-1645
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-12
Last Update Date:2021-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MEMD250422084N0400X
TXL34122084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology