Provider Demographics
NPI:1467431783
Name:BADEA-MIC, DANIELA (MD)
Entity Type:Individual
Prefix:DR
First Name:DANIELA
Middle Name:
Last Name:BADEA-MIC
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:527 GORDON ST
Mailing Address - Street 2:
Mailing Address - City:CORPUS CHRISTI
Mailing Address - State:TX
Mailing Address - Zip Code:78404-2535
Mailing Address - Country:US
Mailing Address - Phone:361-850-8300
Mailing Address - Fax:361-850-8302
Practice Address - Street 1:527 GORDON ST
Practice Address - Street 2:
Practice Address - City:CORPUS CHRISTI
Practice Address - State:TX
Practice Address - Zip Code:78404-2535
Practice Address - Country:US
Practice Address - Phone:361-850-8300
Practice Address - Fax:361-850-8302
Is Sole Proprietor?:Yes
Enumeration Date:2006-01-13
Last Update Date:2011-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXJ68632084P0800X, 363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Multi-Specialty
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX178162701Medicaid
TX101580203Medicaid
TX101580203Medicaid
TX8F1708Medicare PIN
TX838838Medicare PIN