Provider Demographics
NPI:1912091208
Name:WEST, DON MAURICE (MD)
Entity Type:Individual
Prefix:DR
First Name:DON
Middle Name:MAURICE
Last Name:WEST
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 1:1305 AIRPORT FWY STE 302
Mailing Address - Street 2:
Mailing Address - City:BEDFORD
Mailing Address - State:TX
Mailing Address - Zip Code:76021-6604
Mailing Address - Country:US
Mailing Address - Phone:817-283-6995
Mailing Address - Fax:817-952-7011
Practice Address - Street 1:1305 AIRPORT FWY STE 302
Practice Address - Street 2:
Practice Address - City:BEDFORD
Practice Address - State:TX
Practice Address - Zip Code:76021-6604
Practice Address - Country:US
Practice Address - Phone:817-283-6995
Practice Address - Fax:817-952-7011
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-03
Last Update Date:2020-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXG5762225400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225400000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRehabilitation Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX4204222OtherAETNA
TX2035487-03OtherGROUP TPI
TXD07564OtherRR GROUP
TX035411003Medicaid
TXP000QB415Medicaid
TXP01239785OtherRAILROAD PTAN
TXP01239785OtherRAILROAD PTAN
TX00QB41Medicare PIN
TX313729YNEAMedicare PIN
TX035411003Medicaid
TXTXB140567Medicare PIN