Provider Demographics
NPI:1356338412
Name:HOPKINS, DONALD WAYNE (DO)
Entity type:Individual
Prefix:
First Name:DONALD
Middle Name:WAYNE
Last Name:HOPKINS
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11723 FM 580 E
Mailing Address - Street 2:
Mailing Address - City:KEMPNER
Mailing Address - State:TX
Mailing Address - Zip Code:76539-3724
Mailing Address - Country:US
Mailing Address - Phone:512-734-1710
Mailing Address - Fax:512-556-4647
Practice Address - Street 1:11723 FM 580 E
Practice Address - Street 2:
Practice Address - City:KEMPNER
Practice Address - State:TX
Practice Address - Zip Code:76539
Practice Address - Country:US
Practice Address - Phone:512-734-1710
Practice Address - Fax:512-556-4647
Is Sole Proprietor?:Yes
Enumeration Date:2005-10-04
Last Update Date:2019-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXE0058207P00000X, 207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX127032402Medicaid
TX127032406Medicaid
TX8F0110Medicare PIN
TXC17088Medicare UPIN
TXP00227196Medicare PIN
TX127032402Medicaid