Provider Demographics
NPI:1962499244
Name:DOLLE, DONNA SUE (MD)
Entity Type:Individual
Prefix:DR
First Name:DONNA
Middle Name:SUE
Last Name:DOLLE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:2020 NASA PKWY
Mailing Address - Street 2:SUITE 290
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77058-3683
Mailing Address - Country:US
Mailing Address - Phone:281-335-7588
Mailing Address - Fax:281-335-7598
Practice Address - Street 1:2020 NASA PKWY
Practice Address - Street 2:SUITE 290
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77058-3683
Practice Address - Country:US
Practice Address - Phone:281-335-7588
Practice Address - Fax:281-335-7598
Is Sole Proprietor?:Yes
Enumeration Date:2005-10-03
Last Update Date:2011-09-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TXJ6407207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXG33206Medicare UPIN