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General NPI Number Information
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NPI Number | 1992010557
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Entity Type | Organization
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Legal Business Name | RONALD L DANIELS DO PA
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Dates
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Enumeration Date | 08/07/2010
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Last Update Date | 09/23/2010
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Provider Practice Location Address
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Address Line | 117 N WINNSBORO ST
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City | QUITMAN
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State | TX
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Zip | 75783-2144
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Country | US
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Telephone | 903-763-2218
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Fax | 903-763-4308
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Provider Business Mailing Address
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Address Line | PO BOX 895
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City | QUITMAN
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State | TX
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Zip | 75783-0895
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Country | US
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Telephone | 903-763-2218
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Fax | 903-763-4308
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Authorized Official
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Title or Position | PHYSICIAN
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Name | DR. RON LANE DANIELS
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Credential | D.O.
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Telephone | 903-763-2218
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2300X
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Taxonomy Name | Primary Care Clinic/Center
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License Number | E3246
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License Number State | TX
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