Provider Demographics
NPI:1770679573
Name:DANIEL, TIMOTHY (MD)
Entity Type:Individual
Prefix:
First Name:TIMOTHY
Middle Name:
Last Name:DANIEL
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 1:13100 NORTHWEST FWY
Mailing Address - Street 2:SUITE 400
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77040-6310
Mailing Address - Country:US
Mailing Address - Phone:866-693-4223
Mailing Address - Fax:888-237-7954
Practice Address - Street 1:10970 SHADOW CREEK PKWY
Practice Address - Street 2:SUITE 270
Practice Address - City:PEARLAND
Practice Address - State:TX
Practice Address - Zip Code:77584-0100
Practice Address - Country:US
Practice Address - Phone:866-693-4223
Practice Address - Fax:888-237-7954
Is Sole Proprietor?:No
Enumeration Date:2006-10-05
Last Update Date:2013-11-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXL6339207RE0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & Metabolism
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXL6339OtherMEDICAL LICENSE
TX8K8440Medicare PIN