Provider Demographics
NPI:1588797864
Name:CANNEY, DONNA HILL (MD, PHD)
Entity Type:Individual
Prefix:
First Name:DONNA
Middle Name:HILL
Last Name:CANNEY
Suffix:
Gender:F
Credentials:MD, PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1461
Mailing Address - Street 2:
Mailing Address - City:NAVASOTA
Mailing Address - State:TX
Mailing Address - Zip Code:77868-1461
Mailing Address - Country:US
Mailing Address - Phone:936-825-1721
Mailing Address - Fax:935-825-0572
Practice Address - Street 1:222 E WASHINGTON AVE
Practice Address - Street 2:
Practice Address - City:NAVASOTA
Practice Address - State:TX
Practice Address - Zip Code:77868-3028
Practice Address - Country:US
Practice Address - Phone:936-825-1721
Practice Address - Fax:936-825-0572
Is Sole Proprietor?:No
Enumeration Date:2007-03-14
Last Update Date:2011-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXK8882207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1439531-01Medicaid
TX1439531-01Medicaid
TX00277QMedicare PIN