Provider Demographics
NPI:1255480471
Name:BAKER, DONNA J (DC)
Entity Type:Individual
Prefix:DR
First Name:DONNA
Middle Name:J
Last Name:BAKER
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 PLANTATION DR
Mailing Address - Street 2:
Mailing Address - City:LAKE JACKSON
Mailing Address - State:TX
Mailing Address - Zip Code:77566-6153
Mailing Address - Country:US
Mailing Address - Phone:979-297-0336
Mailing Address - Fax:
Practice Address - Street 1:100 PLANTATION DR
Practice Address - Street 2:
Practice Address - City:LAKE JACKSON
Practice Address - State:TX
Practice Address - Zip Code:77566-6153
Practice Address - Country:US
Practice Address - Phone:979-297-0336
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXDC3068111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX601294Medicare ID - Type Unspecified
TXT12039Medicare UPIN