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Individual

DR. JON DANIELL

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
100 HILLCREST MEDICAL BLVD, WACO, TX 76712-8897
(254) 202-5800
Mailing address
PO BOX 844658, DALLAS, TX 75284-4658
(254) 724-8800

Taxonomy

Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
K9761
TX
207P00000X
Emergency Medicine Physician
TBXK9761
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
043877202
TX
01
8C0340
BCBS
TX
01
930104296
RRMCR
TX
Enumeration date
08/31/2006
Last updated
02/11/2015
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