Individual
CHERYL K MCDONALD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
1125 COLLEGE AVE, FORT WORTH, TX 76104-4514
(817) 810-9810
(817) 810-9815
Mailing address
1125 COLLEGE AVE, FORT WORTH, TX 76104-4514
(817) 810-9810
(817) 810-9815
Taxonomy
Speciality
Code
Description
License number
State
207RI0200X
Infectious Disease Physician
Primary
H7634
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
047670701
—
TX
01
—
440002173
MEDICARE RAILROAD
—
01
—
89860J
BCBS
TX
Enumeration date
02/20/2006
Last updated
01/21/2013
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