Provider Demographics
NPI:1477156651
Name:DR DONALD WAYNE HOPKINS
Entity Type:Organization
Organization Name:DR DONALD WAYNE HOPKINS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BILLING MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:LAURA
Authorized Official - Middle Name:L
Authorized Official - Last Name:HUBRED
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:254-424-2698
Mailing Address - Street 1:11723 FM 580 E
Mailing Address - Street 2:
Mailing Address - City:KEMPNER
Mailing Address - State:TX
Mailing Address - Zip Code:76539-3724
Mailing Address - Country:US
Mailing Address - Phone:254-512-1710
Mailing Address - Fax:512-514-4214
Practice Address - Street 1:11723 FM 580 E
Practice Address - Street 2:
Practice Address - City:KEMPNER
Practice Address - State:TX
Practice Address - Zip Code:76539-3724
Practice Address - Country:US
Practice Address - Phone:254-512-1710
Practice Address - Fax:512-514-4214
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-11-19
Last Update Date:2021-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX127032410Medicaid
TX207Q00000XOtherTAXONOMY
VT207P00000XOtherTAXONOMY
TXE0058OtherLICENSE NUMBER