Provider Demographics
NPI:1912904608
Name:DANNA, BERNARD LOUIS JR (DPM)
Entity Type:Individual
Prefix:MR
First Name:BERNARD
Middle Name:LOUIS
Last Name:DANNA
Suffix:JR
Gender:M
Credentials:DPM
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Mailing Address - Street 1:7575 SAN FELIPE ST
Mailing Address - Street 2:301
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77063-1711
Mailing Address - Country:US
Mailing Address - Phone:713-974-4511
Mailing Address - Fax:713-974-4501
Practice Address - Street 1:7575 SAN FELIPE ST
Practice Address - Street 2:301
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77063-1711
Practice Address - Country:US
Practice Address - Phone:713-974-4511
Practice Address - Fax:713-974-4501
Is Sole Proprietor?:Yes
Enumeration Date:2005-07-07
Last Update Date:2013-12-19
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
TXTX0527213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX018826001Medicaid
TX00T559OtherBCBS
TX00T559Medicare PIN
TX018826001Medicaid