Provider Demographics
NPI:1285835603
Name:MCDONALD, HALLIDAY CRAIGE (MD)
Entity Type:Individual
Prefix:MRS
First Name:HALLIDAY
Middle Name:CRAIGE
Last Name:MCDONALD
Suffix:
Gender:F
Credentials:MD
Other - Prefix:MRS
Other - First Name:HELEN
Other - Middle Name:HALLIDAY
Other - Last Name:CRAIGE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:102 WESTLAKE DR STE 103
Mailing Address - Street 2:
Mailing Address - City:WEST LAKE HILLS
Mailing Address - State:TX
Mailing Address - Zip Code:78746-5373
Mailing Address - Country:US
Mailing Address - Phone:512-327-7779
Mailing Address - Fax:
Practice Address - Street 1:102 WESTLAKE DR STE 103
Practice Address - Street 2:
Practice Address - City:WEST LAKE HILLS
Practice Address - State:TX
Practice Address - Zip Code:78746-5373
Practice Address - Country:US
Practice Address - Phone:512-327-7779
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-31
Last Update Date:2022-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXM8173207N00000X
CODR-49057207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
BP2-0026120OtherINSTITUTIONAL PERMIT
BP2-0026120OtherINSTITUTIONAL PERMIT