Provider Demographics
NPI:1487698106
Name:AREGO, DONALD EDWARD (MD)
Entity type:Individual
Prefix:
First Name:DONALD
Middle Name:EDWARD
Last Name:AREGO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:901 TURTLE CREEK DR
Mailing Address - Street 2:
Mailing Address - City:TYLER
Mailing Address - State:TX
Mailing Address - Zip Code:75701-1947
Mailing Address - Country:US
Mailing Address - Phone:903-596-3651
Mailing Address - Fax:903-594-2038
Practice Address - Street 1:701 OLYMPIC PLAZA
Practice Address - Street 2:2ND FLOOR
Practice Address - City:TYLER
Practice Address - State:TX
Practice Address - Zip Code:75701
Practice Address - Country:US
Practice Address - Phone:903-596-3587
Practice Address - Fax:903-594-2647
Is Sole Proprietor?:No
Enumeration Date:2006-06-15
Last Update Date:2014-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXG3116208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXP00067772OtherMEDICARE RR
TX054987502Medicaid
TX8B4583Medicare PIN
TX054987502Medicaid
TXP00067772Medicare PIN