Provider Demographics
NPI:1598923989
Name:TATE, DANA (DPM)
Entity Type:Individual
Prefix:
First Name:DANA
Middle Name:
Last Name:TATE
Suffix:
Gender:F
Credentials:DPM
Other - Prefix:
Other - First Name:DANA
Other - Middle Name:
Other - Last Name:MILBOURNE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DPM
Mailing Address - Street 1:7825 HIGHWAY 6 N STE 110
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77095-1705
Mailing Address - Country:US
Mailing Address - Phone:281-463-7208
Mailing Address - Fax:281-463-1035
Practice Address - Street 1:7825 HIGHWAY 6 N STE 110
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77095-1705
Practice Address - Country:US
Practice Address - Phone:281-463-7208
Practice Address - Fax:281-463-1035
Is Sole Proprietor?:Yes
Enumeration Date:2008-06-02
Last Update Date:2022-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1928174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXTXB101312Medicare PIN