JACQUELINE S O'DONALD, M.D., PA
NPI 1134432412
Specialist in Texarkana, TX

Active since July 15, 2010
3510 RICHMOND RD STE 100, TEXARKANA, TX 75503(903) 831-3033(903) 831-3032 Get Directions Write a Review

NPPES record last updated: October 22, 2010. Verified against the NPPES registry weekly; last sync: July 19, 2026.

  • Organization
  • Specialist

About JACQUELINE S O'DONALD, M.D., PA

This page provides the complete NPI Profile along with additional information for Jacqueline S O'donald, M.d., Pa, a provider established in Texarkana, Texas operating as a Specialist. The healthcare provider is registered in the NPI registry with number 1134432412 assigned on July 2010. The practitioner's primary taxonomy code is 174400000X with license number L3496 (TX). The provider is registered as an organization and their NPI record was last updated 16 years ago. The organization operates as a Single Specialty Group with one or more individual practitioners, all of who practice with the same area of specialization. The authorized official of this NPI record is Mrs. Lisa Ann Carlton Cca, Cmis (Insurance/billing)

NPI
1134432412 Verify this NPI
Provider Name
JACQUELINE S O'DONALD, M.D., PA
Entity Type
Organization
Location Address
3510 RICHMOND RD STE 100 TEXARKANA, TX 75503
Location Phone
(903) 831-3033
Location Fax
(903) 831-3032
Mailing Address
3510 RICHMOND ROAD, STE 100 TEXARKANA, TX 75503
Mailing Phone
(903) 831-3033
Mailing Fax
(903) 831-3032
Is Sole Proprietor?
No
Is Organization Subpart?
No
Enumeration Date
07-15-2010
Last Update Date
10-22-2010
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Specialty - Primary Taxonomy

The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Classification

Specialist

Taxonomy Code
174400000X
Type
Other Service Providers
License No.
L3496
License State
TX
Taxonomy Description
An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree.

Group Taxonomy 193400000X SINGLE SPECIALTY GROUP

This provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.

Insurance Plans Accepted

According to publicly available information the provider might be accepting the following health plans from these health insurance companies:

Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.

Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.

*Please verify directly with this provider to make sure your insurance plan is currently accepted.

Authorized Official

The authorized official is the designated individual with the legal authority to make changes to the provider’s official NPI record. For organizations, the authorized official must be a general partner, chairman of the board, CEO, CFO or a direct owner holding at least a 5 percent stake in the medical organization.

Authorized Official Name

MRS. LISA ANN CARLTON CCA, CMIS

Authorized Official Title
INSURANCE/BILLING
Authorized Official Phone
(903) 831-3033

Additional Identifiers

The NPI Enumerator encourages providers to submit additional identifiers with their NPI application although the submission of this information is optional. The additional identifier(s) section includes other numbers or codes currently or formerly used as an identifier for the provider by other public healthcare entities. The identifiers may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.

Identifier Type / Code Identifier State Identifier Issuer
8C7165MEDICARE UPIN (02)TX 

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Other Providers at the Same Location


The following 3 providers are registered at the same or a nearby location.

Internal Medicine
3510 RICHMOND RD STE 100
TEXARKANA, TX 75503
Nurse Practitioner (Family)
3510 RICHMOND RD STE 100
TEXARKANA, TX 75503
Family Medicine
3510 RICHMOND RD STE 100
TEXARKANA, TX 75503

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1134432412, enumerated as an "organization" on July 15, 2010.

The provider is located at 3510 RICHMOND RD STE 100 TEXARKANA, TX 75503 and the phone number is (903) 831-3033.

Specialist with taxonomy code 174400000X.

The provider might be accepting Accepts: Medicare and Medicaid. Please consult your insurance carrier or call the provider to verify.