Provider Demographics
NPI:1487287041
Name:O'QUINN, DANIEL PATRICK
Entity type:Individual
Prefix:
First Name:DANIEL
Middle Name:PATRICK
Last Name:O'QUINN
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4201 S CONGRESS AVE STE 202
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78745-1156
Mailing Address - Country:US
Mailing Address - Phone:512-914-1862
Mailing Address - Fax:
Practice Address - Street 1:4201 S CONGRESS AVE STE 202
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78745-1156
Practice Address - Country:US
Practice Address - Phone:512-914-1862
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-02-21
Last Update Date:2020-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX40764101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)