MEDICARE: TONYA PATRICE MCDONALD MD

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	208000000X	Pediatrics Physician	P4888	TX
2	208000000X	Pediatrics Physician	A84239	CA

General Provider Information

NPI Number	:	1376509745
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TONYA PATRICE MCDONALD MD

Provider Business Mailing Address
First Line	:	4428 MAIN ST STE 100
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75226-1119
Country	:	US
Telephone Number	:	469-431-2627
Fax Number	:	469-754-0730

Provider Business Practice Location Address
First Line	:	3560 W CAMP WISDOM RD STE 200
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75237-2513
Country	:	US
Telephone Number	:	469-431-2627
Fax Number	:	469-754-0730

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

Provider Enumeration Date	:	04/25/2006
Last Update Date	:	12/04/2025

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