Individual
DR. DONALD L IDEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
4521 S STAPLES ST, STE 100, CORPUS CHRISTI, TX 78411-2603
(361) 993-9363
(361) 993-9366
Mailing address
4521 S STAPLES ST, STE 100, CORPUS CHRISTI, TX 78411-2603
(361) 993-9363
(361) 993-9366
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
E 6811
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
BS # K40V
BLUE CROSS IDENTIFIER
TX
Enumeration date
06/22/2005
Last updated
07/21/2022
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