Provider Demographics
NPI:1437187713
Name:SKOGLUND, DANIEL NEIL (MD)
Entity Type:Individual
Prefix:
First Name:DANIEL
Middle Name:NEIL
Last Name:SKOGLUND
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3305 NORTHLAND DR
Mailing Address - Street 2:#401
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78731-4961
Mailing Address - Country:US
Mailing Address - Phone:512-419-0100
Mailing Address - Fax:512-419-0185
Practice Address - Street 1:3305 NORTHLAND DR
Practice Address - Street 2:#401
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78731-4961
Practice Address - Country:US
Practice Address - Phone:512-419-0100
Practice Address - Fax:512-419-0185
Is Sole Proprietor?:No
Enumeration Date:2006-06-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TXK34752084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
G56719Medicare UPIN