Provider Demographics
NPI:1538144118
Name:DURAN, DONNA M (MD)
Entity Type:Individual
Prefix:
First Name:DONNA
Middle Name:M
Last Name:DURAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Other - Last Name:
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Mailing Address - Street 1:11797 SOUTH FWY STE 238
Mailing Address - Street 2:
Mailing Address - City:BURLESON
Mailing Address - State:TX
Mailing Address - Zip Code:76028-7035
Mailing Address - Country:US
Mailing Address - Phone:817-568-2277
Mailing Address - Fax:817-568-2254
Practice Address - Street 1:11797 SOUTH FWY STE 238
Practice Address - Street 2:
Practice Address - City:BURLESON
Practice Address - State:TX
Practice Address - Zip Code:76028-7035
Practice Address - Country:US
Practice Address - Phone:817-568-2277
Practice Address - Fax:817-568-2254
Is Sole Proprietor?:Yes
Enumeration Date:2005-12-07
Last Update Date:2021-11-05
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TXJ6413207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX122042801Medicaid
TX0004CAOtherBLUE CROSS BLUE SHIELD
TX122042801OtherSUPERIOR HEALTH CHIPS
TX1316114952Medicaid
TX752837796OtherHMHS/TRICARE
TX160052753OtherMEDICARE RAILROAD
TX752837796OtherHMHS/TRICARE
TX1316114952Medicaid