Provider Demographics
NPI:1508478256
Name:DONK, MIGUEL IRVIN (COTA)
Entity Type:Individual
Prefix:
First Name:MIGUEL
Middle Name:IRVIN
Last Name:DONK
Suffix:
Gender:M
Credentials:COTA
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:1435 WINDMILL LN
Mailing Address - Street 2:
Mailing Address - City:MESQUITE
Mailing Address - State:TX
Mailing Address - Zip Code:75149-6853
Mailing Address - Country:US
Mailing Address - Phone:786-444-6828
Mailing Address - Fax:
Practice Address - Street 1:13727 NOEL RD STE 200
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75240-1338
Practice Address - Country:US
Practice Address - Phone:972-851-1022
Practice Address - Fax:972-546-3118
Is Sole Proprietor?:Yes
Enumeration Date:2020-08-22
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant