Provider Demographics
NPI:1912077025
Name:LONGEE, DARRYL C (MD)
Entity Type:Individual
Prefix:
First Name:DARRYL
Middle Name:C
Last Name:LONGEE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7355 BARLITE BLVD
Mailing Address - Street 2:SUITE 201
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78224-1342
Mailing Address - Country:US
Mailing Address - Phone:210-928-7538
Mailing Address - Fax:210-921-2552
Practice Address - Street 1:7355 BARLITE BLVD
Practice Address - Street 2:SUITE 201
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78224-1342
Practice Address - Country:US
Practice Address - Phone:210-928-7538
Practice Address - Fax:210-921-2552
Is Sole Proprietor?:No
Enumeration Date:2006-11-08
Last Update Date:2011-04-05
Deactivation Date:2008-11-11
Deactivation Code:
Reactivation Date:2008-11-26
Provider Licenses
StateLicense IDTaxonomies
TX423302080P0207X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0207XAllopathic & Osteopathic PhysiciansPediatricsPediatric Hematology-Oncology