Provider Demographics
NPI:1659375350
Name:PRIOUR, DONALD J (MD)
Entity Type:Individual
Prefix:DR
First Name:DONALD
Middle Name:J
Last Name:PRIOUR
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 1:961 WATER ST
Mailing Address - Street 2:
Mailing Address - City:KERRVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:78028-3541
Mailing Address - Country:US
Mailing Address - Phone:830-896-3822
Mailing Address - Fax:830-896-3835
Practice Address - Street 1:961 WATER ST
Practice Address - Street 2:
Practice Address - City:KERRVILLE
Practice Address - State:TX
Practice Address - Zip Code:78028-3541
Practice Address - Country:US
Practice Address - Phone:830-896-3822
Practice Address - Fax:830-896-3835
Is Sole Proprietor?:Yes
Enumeration Date:2005-06-09
Last Update Date:2008-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXD9613207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX031878401Medicaid
TXB25652Medicare UPIN
TX031878401Medicaid