Provider Demographics
NPI:1669440244
Name:VEGEAIS, DONNA S (MD)
Entity Type:Individual
Prefix:
First Name:DONNA
Middle Name:S
Last Name:VEGEAIS
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:14500 BLANCO RD
Mailing Address - Street 2:APT. #1411
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78216-7858
Mailing Address - Country:US
Mailing Address - Phone:210-540-0804
Mailing Address - Fax:
Practice Address - Street 1:3851 ROGER BROOKE DR
Practice Address - Street 2:BROOKE ARMY MEDICAL CENTER MCHE-QD/CREDENTIALS
Practice Address - City:FORT SAM HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:78234-4501
Practice Address - Country:US
Practice Address - Phone:210-916-2460
Practice Address - Fax:210-916-5102
Is Sole Proprietor?:No
Enumeration Date:2006-03-09
Last Update Date:2013-04-08
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Provider Licenses
StateLicense IDTaxonomies
WI47740207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI34630100Medicaid
WI34630100Medicaid