Provider Demographics
NPI:1609840784
Name:MCDONALD, DUNCAN (PT)
Entity Type:Individual
Prefix:MR
First Name:DUNCAN
Middle Name:
Last Name:MCDONALD
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11450 ROJAS DR
Mailing Address - Street 2:STE D1
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79936
Mailing Address - Country:US
Mailing Address - Phone:915-633-8600
Mailing Address - Fax:915-633-8700
Practice Address - Street 1:11450 ROJAS DR
Practice Address - Street 2:STE D1
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79936
Practice Address - Country:US
Practice Address - Phone:915-633-8600
Practice Address - Fax:915-633-8700
Is Sole Proprietor?:Yes
Enumeration Date:2006-02-15
Last Update Date:2014-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX186833225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX8T0981OtherBCBS
TX0019JZOtherGROUP BCBS
TX163264801Medicaid
TX0019JZOtherGROUP BCBS
TX8T0981OtherBCBS
TX8B1274Medicare ID - Type Unspecified