Provider Demographics
NPI:1942414982
Name:COPELAND, DANIEL R (MD)
Entity Type:Individual
Prefix:DR
First Name:DANIEL
Middle Name:R
Last Name:COPELAND
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:2405 W MISSOURI AVE
Mailing Address - Street 2:
Mailing Address - City:MIDLAND
Mailing Address - State:TX
Mailing Address - Zip Code:79701-6800
Mailing Address - Country:US
Mailing Address - Phone:432-697-1061
Mailing Address - Fax:432-697-7089
Practice Address - Street 1:2405 W MISSOURI AVE
Practice Address - Street 2:
Practice Address - City:MIDLAND
Practice Address - State:TX
Practice Address - Zip Code:79701-6800
Practice Address - Country:US
Practice Address - Phone:432-697-1061
Practice Address - Fax:432-697-7089
Is Sole Proprietor?:No
Enumeration Date:2007-05-09
Last Update Date:2015-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR390200000X208600000X
TXP53522086S0129X, 2086S0127X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086S0129XAllopathic & Osteopathic PhysiciansSurgeryVascular Surgery
No208600000XAllopathic & Osteopathic PhysiciansSurgery
No2086S0127XAllopathic & Osteopathic PhysiciansSurgeryTrauma Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX304433YT4FOtherMEDICARE
TX324891601Medicaid
TX8DV506OtherBLUE CROSS