Individual
DONALD DAVID BACON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1202 E SONTERRA BLVD STE 101, SAN ANTONIO, TX 78258-4238
(210) 546-1410
(210) 546-1419
Mailing address
1202 E SONTERRA BLVD, STE 101, SAN ANTONIO, TX 78258-3944
(210) 546-1410
(210) 546-1419
Taxonomy
Speciality
Code
Description
License number
State
208VP0000X
Pain Medicine Physician
Primary
E2452
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
134975503
—
TX
Enumeration date
07/19/2005
Last updated
07/21/2022
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