Individual provider Active NPI

Danette Marlene Persyn, M.D.

  • General Practice Physician
  • The Woodlands, TX
National Provider Identifier
1699074831
Registry record updated Jun 14, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
License
L3067 Issued in TX
Practice address
10077 Grogans Mill Rd
Suite 460
The Woodlands, TX 77380-1000
Phone
(281) 465-3600
Fax
(281) 465-3608
NPI assigned
Mar 25, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 14, 2011

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Physician 208D00000X L3067 TX Primary

Addresses

Primary practice location

10077 Grogans Mill Rd
Suite 460
The Woodlands, TX 77380-1000

Mailing address

10077 Grogans Mill Rd
Suite 460
The Woodlands, TX 77380-1000
Phone (281) 465-3600

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
L3067TXMDGeneral Practice Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Farmer Dermatology, PLLC PastSince May 11, 2011 Accepting new patients
The Suchowiecky Center Past Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1301011200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1308009600000",
    "number": "1699074831",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10077 GROGANS MILL RD",
            "address_2": "SUITE 460",
            "city": "THE WOODLANDS",
            "state": "TX",
            "postal_code": "773801000",
            "telephone_number": "281-465-3600",
            "fax_number": "281-465-3608"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10077 GROGANS MILL RD",
            "address_2": "SUITE 460",
            "city": "THE WOODLANDS",
            "state": "TX",
            "postal_code": "773801000",
            "telephone_number": "281-465-3600",
            "fax_number": "281-465-3608"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PERSYN",
        "first_name": "DANETTE",
        "middle_name": "MARLENE",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-03-25",
        "last_updated": "2011-06-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "TX",
            "license": "L3067",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in The Woodlands, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 14, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.