Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | M1066 | TX |
N | 111NI0900X | Internist | M1066 | TX |
Y | 207RX0202X | Medical Oncology | M1066 | TX |
NPI | 1093918617 |
---|---|
Provider Name | Dr. David Michael Dspain |
First Address | Dallas, TX 75391-1230 |
Second Address | Weatherford, TX 76086-5713 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 10/06/2007 |
Last Update Date | 08/06/2011 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
193472101 | (05) | TX |
193472102 | (05) | TX |
193472103 | (05) | TX |
P00620585 | RAILROAD MEDICARE (01) | TX |