Daniel Gerardo Izquierdo, PA

Primary specialty

Surgical Physician AssistantTaxonomy code 363AS0400X

License

PA11409 Issued in TX

Practice address

Martin Army Community Hospital
Fort Benning, GA 31905

Phone

(706) 544-2258

NPI assigned

May 15, 2007

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

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.

• Doctx3 PLLC

  • Orthopaedic Surgery Physician
  • Irving, TX
  • NPI 1467808618

  Multi-Specialty

  NPD (past)

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

{
    "created_epoch": "1179187200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1552435200000",
    "number": "1942416292",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2419 W SOUTHLAKE BLVD",
            "address_2": "STE 100",
            "city": "SOUTHLAKE",
            "state": "TX",
            "postal_code": "760921506",
            "telephone_number": "706-610-5717"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "MARTIN ARMY COMMUNITY HOSPITAL",
            "city": "FORT BENNING",
            "state": "GA",
            "postal_code": "31905",
            "telephone_number": "706-544-2258"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "IZQUIERDO",
        "first_name": "DANIEL",
        "middle_name": "GERARDO",
        "credential": "PA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-05-15",
        "last_updated": "2019-03-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physician Assistant, Surgical",
            "state": "TX",
            "license": "PA11409",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Michelle Icasiano
• Bruce David Ingold, PA-C
• Kimberly Ann Saya Inouye, DMD
• Thomas Isenovski, DO
• Heather Isom
• Annabelle M Jackson
• Warren T Jahn, DC
• Corella James-Johnson, PA-C
• Hee Sub Jang
• John B Jennette, M.D.

• Surgical Physician Assistant in Fort Benning, GA
• Providers in Fort Benning, GA by specialty
• Surgical Physician Assistant in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 13, 2019; 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.