Individual
DAVID LEE MCDONALD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OD
Contact information
Practice address
1787 US HWY 79 S, HENDERSON, TX 75654
(903) 657-1539
(903) 657-0259
Mailing address
1787 US HWY 79 S, HENDERSON, TX 75654
(903) 657-1539
(903) 657-0259
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
5144TG
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00Z051
MEDICARE GROUP
TX
05
—
110677504
—
TX
01
—
142624902
MEDICAID GROUP
TX
Enumeration date
10/20/2006
Last updated
06/16/2016
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