Provider Demographics
NPI:1336536143
Name:CONDIE, DANIEL (MD)
Entity Type:Individual
Prefix:
First Name:DANIEL
Middle Name:
Last Name:CONDIE
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:5310 HARVEST HILL RD
Mailing Address - Street 2:STE 290
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75230-5826
Mailing Address - Country:US
Mailing Address - Phone:214-420-0650
Mailing Address - Fax:214-736-0512
Practice Address - Street 1:3530 S VAL VISTA DR # B109
Practice Address - Street 2:
Practice Address - City:GILBERT
Practice Address - State:AZ
Practice Address - Zip Code:85297-7318
Practice Address - Country:US
Practice Address - Phone:480-905-8485
Practice Address - Fax:480-905-7274
Is Sole Proprietor?:No
Enumeration Date:2015-04-20
Last Update Date:2021-07-27
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
TXS0650207ND0101X, 207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
No207ND0101XAllopathic & Osteopathic PhysiciansDermatologyMOHS-Micrographic Surgery