Provider Demographics
NPI:1619089166
Name:ECHOLS, DAALON BRAUNDRE (MD)
Entity Type:Individual
Prefix:
First Name:DAALON
Middle Name:BRAUNDRE
Last Name:ECHOLS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3703 RAVEN CT
Mailing Address - Street 2:
Mailing Address - City:MANVEL
Mailing Address - State:TX
Mailing Address - Zip Code:77578-3194
Mailing Address - Country:US
Mailing Address - Phone:832-336-4443
Mailing Address - Fax:832-336-4443
Practice Address - Street 1:3703 RAVEN CT
Practice Address - Street 2:
Practice Address - City:MANVEL
Practice Address - State:TX
Practice Address - Zip Code:77578-3194
Practice Address - Country:US
Practice Address - Phone:832-336-4443
Practice Address - Fax:832-336-4443
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-31
Last Update Date:2018-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXM40492084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXM4049OtherMEDICAL LICENSE
I68255Medicare UPIN
TXM4049OtherMEDICAL LICENSE