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General NPI Number Information
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NPI Number | 1164683298
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Entity Type | Organization
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Legal Business Name | DAVE E WEBSTER D.O., PA
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Dates
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Enumeration Date | 06/20/2008
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Last Update Date | 11/24/2008
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Provider Practice Location Address
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Address Line | 5610 E CENTRAL TEXAS EXPY SUITE 1
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City | KILLEEN
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State | TX
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Zip | 76543-5519
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Country | US
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Telephone | 254-690-8887
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Fax | 264-690-6696
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Provider Business Mailing Address
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Address Line | PO BOX 2909
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City | HARKER HEIGHTS
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State | TX
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Zip | 76548-0909
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Country | US
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Telephone | 254-690-8887
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Fax | 254-690-6696
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Authorized Official
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Title or Position | OWNER/CEO
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Name | DAVE E WEBSTER
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Credential | D.O.
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Telephone | 254-690-8887
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2300X
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Taxonomy Name | Primary Care Clinic/Center
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License Number | E5982
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License Number State | TX
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