Provider Demographics
NPI:1720120264
Name:VAN HOOFF, DONALD (NP)
Entity Type:Individual
Prefix:
First Name:DONALD
Middle Name:
Last Name:VAN HOOFF
Suffix:
Gender:M
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:804 WOOD DUCK WAY
Mailing Address - Street 2:
Mailing Address - City:FLOWER MOUND
Mailing Address - State:TX
Mailing Address - Zip Code:75028-7275
Mailing Address - Country:US
Mailing Address - Phone:469-293-5911
Mailing Address - Fax:
Practice Address - Street 1:131 DEGAN AVE
Practice Address - Street 2:SUITE #105
Practice Address - City:LEWISVILLE
Practice Address - State:TX
Practice Address - Zip Code:75057-3622
Practice Address - Country:US
Practice Address - Phone:972-317-6600
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-02-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX546135363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health