Provider Demographics
NPI:1275524597
Name:PIERCE, DANEANE (RPT)
Entity Type:Individual
Prefix:
First Name:DANEANE
Middle Name:
Last Name:PIERCE
Suffix:
Gender:F
Credentials:RPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1005 W RALPH HALL
Mailing Address - Street 2:SUITE 201
Mailing Address - City:ROCKWALL
Mailing Address - State:TX
Mailing Address - Zip Code:75032-6658
Mailing Address - Country:US
Mailing Address - Phone:972-771-9081
Mailing Address - Fax:972-772-7102
Practice Address - Street 1:1005 W RALPH HALL
Practice Address - Street 2:SUITE 201
Practice Address - City:ROCKWALL
Practice Address - State:TX
Practice Address - Zip Code:75032-6658
Practice Address - Country:US
Practice Address - Phone:972-771-9081
Practice Address - Fax:972-772-7102
Is Sole Proprietor?:No
Enumeration Date:2005-11-04
Last Update Date:2008-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1133395174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1133395OtherRPT LICENSE
TX1133395OtherRPT LICENSE