Provider Demographics
NPI:1679397301
Name:DONATO, DEXTER (RN)
Entity type:Individual
Prefix:MR
First Name:DEXTER
Middle Name:
Last Name:DONATO
Suffix:
Gender:M
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1000 W YELLOWJACKET LN APT 2708
Mailing Address - Street 2:
Mailing Address - City:ROCKWALL
Mailing Address - State:TX
Mailing Address - Zip Code:75087-4663
Mailing Address - Country:US
Mailing Address - Phone:689-249-1281
Mailing Address - Fax:
Practice Address - Street 1:1000 W YELLOWJACKET LN APT 2708
Practice Address - Street 2:
Practice Address - City:ROCKWALL
Practice Address - State:TX
Practice Address - Zip Code:75087-4663
Practice Address - Country:US
Practice Address - Phone:689-249-1281
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-11-11
Last Update Date:2024-11-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95372992163W00000X
TX1059303163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse