Provider Demographics
NPI:1568496982
Name:BERNSTEIN, DONALD (DO)
Entity Type:Individual
Prefix:
First Name:DONALD
Middle Name:
Last Name:BERNSTEIN
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3427 TRINITY MILLS RD STE 800
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75287-6202
Mailing Address - Country:US
Mailing Address - Phone:972-862-8600
Mailing Address - Fax:972-307-5963
Practice Address - Street 1:3427 TRINITY MILLS RD STE 800
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75287-6202
Practice Address - Country:US
Practice Address - Phone:972-862-8600
Practice Address - Fax:972-307-5963
Is Sole Proprietor?:No
Enumeration Date:2006-07-10
Last Update Date:2014-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXD1185207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX122461003Medicaid
TX122461005Medicaid
TX8G0382Medicare PIN
TX122461003Medicaid
TX122461005Medicaid