Healthcare Provider Details

I. General information

NPI: 1902817612
Provider Name (Legal Business Name): JAMES A DONNEL JR MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/10/2006
Last Update Date: 08/21/2023
Certification Date: 08/21/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10350 BANDERA RD STE 210
SAN ANTONIO TX
78250-5616
US

IV. Provider business mailing address

10350 BANDERA RD STE 210
SAN ANTONIO TX
78250-5616
US

V. Phone/Fax

Practice location:
  • Phone: 210-688-0088
  • Fax: 210-688-0089
Mailing address:
  • Phone: 210-688-0088
  • Fax: 210-688-0089

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberL5308
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: