Provider Demographics
NPI:1760445274
Name:LENDER, DAN (MD)
Entity Type:Individual
Prefix:
First Name:DAN
Middle Name:
Last Name:LENDER
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 1:890 ROCKWALL PKWY STE 102
Mailing Address - Street 2:
Mailing Address - City:ROCKWALL
Mailing Address - State:TX
Mailing Address - Zip Code:75032-6871
Mailing Address - Country:US
Mailing Address - Phone:972-475-5600
Mailing Address - Fax:972-475-5668
Practice Address - Street 1:890 ROCKWALL PKWY STE 102
Practice Address - Street 2:
Practice Address - City:ROCKWALL
Practice Address - State:TX
Practice Address - Zip Code:75032-6871
Practice Address - Country:US
Practice Address - Phone:972-475-5600
Practice Address - Fax:972-475-5668
Is Sole Proprietor?:No
Enumeration Date:2006-04-07
Last Update Date:2020-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD38003207RE0101X
TXJ1293207RE0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & Metabolism
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX105920604Medicaid
TX105920605Medicaid
TX105920603Medicaid
WV3810000990Medicaid
MD611595-01OtherBLUE CROSS/BLUE SHIELD
MD683504000Medicaid
MD683504000Medicaid
MD611595-01OtherBLUE CROSS/BLUE SHIELD
TX105920603Medicaid
TXTXB137930Medicare PIN
MD460242195Medicare PIN
TX105920604Medicaid