Donald L Head, MD
Individual provider Active NPI Family Medicine Physician · Buffalo, TX
NPI 1699799155 · NPPES record last updated Sep 27, 2018
Key facts
- NPI
- 1699799155
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Medicine Physician 207Q00000X
- License
- G8540 (TX)
- Practice address
- 249 Craig St
Buffalo, TX 75831-7707 - Phone
- (903) 322-4072
- Fax
- (903) 322-4069
- NPI assigned
- Jul 27, 2006
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 3
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in TX
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20070522000653 | TX | Practitioner - Emergency Medicine |
8820077100 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Christus Trinity Clinic Texas | Current |
Accepting new patients | |
| Christus Trinity Clinic Texas | Family Medicine | Current |
Accepting new patients |
| East Texas Medical Center Healthcare Associates | Past | Accepting new patients |
Locations
249 S Craig St
Buffalo, TX 75831
Phone (903) 322-1080
125 Newman St
Fairfield, TX 75840
Phone (888) 250-2326
630 S Fleishel Ave
Tyler, TX 75701
Phone (903) 510-8888
Interoperability endpoints
- dhead148635@direct.tmfhs.org
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Physician | 208D00000X | G8540 | TX | |
| Family Medicine Physician | 207Q00000X | G8540 | TX | Yes |
Addresses
Primary practice location
249 Craig St
Buffalo, TX 75831-7707
Mailing address
PO Box 846098
Dallas, TX 75284-6098
Phone (903) 324-6400
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 138779719 | Medicaid | TX |
Other providers in Buffalo, TX
- Kylan Leigh Ferguson
- Mona Jill Ferguson
- Andrena Pauline Glick
- Mikel David Gonzales
- Brittany Celeste Haritos
- Holladay Chiropractic
- Monica Lynn Holladay
- Lori Anne Irons
- Anna L Landry
- Brittany Melissa Lyon
All providers in Buffalo, TX · Family Medicine Physician in Texas
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 27, 2018. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.