MEDICARE: DR. DONALD L IDEN M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	174400000X	Specialist	E 6811	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	BS # K40V	OTHER	TX	BLUE CROSS IDENTIFIER

General Provider Information

NPI Number	:	1013913318
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DONALD L IDEN M.D.

Provider Business Mailing Address
First Line	:	4521 S STAPLES ST
Second Line	:	STE 100
City	:	CORPUS CHRISTI
State	:	TX
Zip	:	78411-2603
Country	:	US
Telephone Number	:	361-993-9363
Fax Number	:	361-993-9366

Provider Business Practice Location Address
First Line	:	4521 S STAPLES ST
Second Line	:	STE 100
City	:	CORPUS CHRISTI
State	:	TX
Zip	:	78411-2603
Country	:	US
Telephone Number	:	361-993-9363
Fax Number	:	361-993-9366

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/22/2005
Last Update Date	:	07/21/2022

Similar Medicare Providers

1104768639 — JULIE MARIE AESTHETICS LLC
Practice Location Address:

4521 S STAPLES ST
CORPUS CHRISTI, TX
78411-2603

Practice Phone: 361-299-5317
Practice Fax: 361-431-1103

1437125036 — THELMA LOPEZ-LIRA MD
Practice Location Address:

4525 S STAPLES ST
CORPUS CHRISTI, TX
78411-2603

Practice Phone: 361-980-1201
Practice Fax: 361-980-1401

1982660338 — DR. ANN ALEMAN WEINMANN MD
Practice Location Address:

4525 S STAPLES ST
CORPUS CHRISTI, TX
78411-2603

Practice Phone: 361-882-7300
Practice Fax:

1891828026 — AFFILLIATED DERMATOLOGISTS OF CORPUS CHRISTI P.A.
Practice Location Address:

4521 S STAPLES ST STE 100
CORPUS CHRISTI, TX
78411-2603

Practice Phone: 361-993-9363
Practice Fax: 361-993-9366

1790016533 — SERGIO H LUNA, MDPA
Practice Location Address:

4525 S STAPLES ST
CORPUS CHRISTI, TX
78411-2603

Practice Phone: 361-653-1612
Practice Fax: 361-980-1401

1831490705 — THELMA LOPEZ-LIRA, MDPA
Practice Location Address:

4525 S STAPLES ST
CORPUS CHRISTI, TX
78411-2603

Practice Phone: 361-980-1201
Practice Fax: 361-980-1401

Directions to “ DR. DONALD L IDEN M.D.” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.