Individual
MR. DONALD L. MACDONALD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LCSW
Contact information
Practice address
616 W RUSSELL PL, SAN ANTONIO, TX 78212-3658
(800) 257-8715
(800) 819-1655
Mailing address
1308 RIVER BEND RD, TYLER, TX 75703-3491
(903) 561-4869
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
S08153
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
86252Q
BLUE CROSS BLUE SHIELD
TX
Enumeration date
11/09/2006
Last updated
07/08/2007
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