Provider Demographics
NPI:1952381618
Name:APODACA, DON (MD)
Entity Type:Individual
Prefix:DR
First Name:DON
Middle Name:
Last Name:APODACA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:7996 E US HIGHWAY 158
Mailing Address - Street 2:
Mailing Address - City:GARDENDALE
Mailing Address - State:TX
Mailing Address - Zip Code:79758-4324
Mailing Address - Country:US
Mailing Address - Phone:432-563-8062
Mailing Address - Fax:432-563-7990
Practice Address - Street 1:1105 ELIZABETH ST
Practice Address - Street 2:
Practice Address - City:RANKIN
Practice Address - State:TX
Practice Address - Zip Code:79778
Practice Address - Country:US
Practice Address - Phone:432-693-2442
Practice Address - Fax:432-693-2504
Is Sole Proprietor?:Yes
Enumeration Date:2006-01-19
Last Update Date:2011-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXE5340207P00000X, 207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXE5340Medicare UPIN