Provider Demographics
NPI:1356444889
Name:COUNTS, DONALD RAY (MD)
Entity Type:Individual
Prefix:
First Name:DONALD
Middle Name:RAY
Last Name:COUNTS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2905 SAN GABRIEL ST
Mailing Address - Street 2:STE 306
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78705-3500
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2905 SAN GABRIEL ST
Practice Address - Street 2:STE 306
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78705-3500
Practice Address - Country:US
Practice Address - Phone:512-474-2772
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-09-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX065427164X00000X
TXD9404207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered164X00000XNursing Service ProvidersLicensed Vocational Nurse
Not Answered207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
B21995Medicare UPIN