Provider Demographics
NPI:1881725075
Name:DONNA ELLEN NEWSOME
Entity type:Organization
Organization Name:DONNA ELLEN NEWSOME
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:
Authorized Official - First Name:DONNA
Authorized Official - Middle Name:ELLEN
Authorized Official - Last Name:NEWSOME
Authorized Official - Suffix:
Authorized Official - Credentials:MD, PHD
Authorized Official - Phone:214-556-1595
Mailing Address - Street 1:900 N WALNUT CREEK DR
Mailing Address - Street 2:STE. 100#211
Mailing Address - City:MANSFIELD
Mailing Address - State:TX
Mailing Address - Zip Code:76063-8046
Mailing Address - Country:US
Mailing Address - Phone:214-556-1595
Mailing Address - Fax:214-556-1645
Practice Address - Street 1:900 N WALNUT CREEK DR
Practice Address - Street 2:STE. 100#211
Practice Address - City:MANSFIELD
Practice Address - State:TX
Practice Address - Zip Code:76063-8046
Practice Address - Country:US
Practice Address - Phone:214-556-1595
Practice Address - Fax:214-556-1645
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-08
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXL34122084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurologyGroup - Single Specialty