Provider Demographics
NPI:1659386001
Name:DONHAM, GUYLE P (DO)
Entity Type:Individual
Prefix:DR
First Name:GUYLE
Middle Name:P
Last Name:DONHAM
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Mailing Address - Street 1:437 TIMBERCREEK CIR
Mailing Address - Street 2:
Mailing Address - City:STEPHENVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:76401-7676
Mailing Address - Country:US
Mailing Address - Phone:254-879-4910
Mailing Address - Fax:254-879-4991
Practice Address - Street 1:10201 HIGHWAY 16
Practice Address - Street 2:
Practice Address - City:COMANCHE
Practice Address - State:TX
Practice Address - Zip Code:76442-4462
Practice Address - Country:US
Practice Address - Phone:254-879-4910
Practice Address - Fax:254-879-4991
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-31
Last Update Date:2008-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXL7716207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX176788102Medicaid
TX176788102Medicaid
TX612213Medicare PIN