Provider Demographics
NPI:1770697906
Name:DONNER, LINDA ANNE (PAC)
Entity type:Individual
Prefix:
First Name:LINDA
Middle Name:ANNE
Last Name:DONNER
Suffix:
Gender:F
Credentials:PAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2060 MARSHALL RD
Mailing Address - Street 2:
Mailing Address - City:WAXAHACHIE
Mailing Address - State:TX
Mailing Address - Zip Code:75167-9419
Mailing Address - Country:US
Mailing Address - Phone:972-923-3215
Mailing Address - Fax:
Practice Address - Street 1:1280 N TOWN EAST BLVD
Practice Address - Street 2:
Practice Address - City:MESQUITE
Practice Address - State:TX
Practice Address - Zip Code:75150-4606
Practice Address - Country:US
Practice Address - Phone:972-686-1880
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-17
Last Update Date:2012-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXPA03116363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXPA03116OtherPHYSICIAN ASSISTANTS