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General NPI Number Information
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NPI Number | 1831404565
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Entity Type | Organization
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Legal Business Name | DAVID T. PRICE, MD, PA
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Dates
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Enumeration Date | 08/18/2010
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Last Update Date | 11/07/2012
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Provider Practice Location Address
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Address Line | 1111 W FRANK AVE SUITE 303
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City | LUFKIN
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State | TX
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Zip | 75904-3303
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Country | US
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Telephone | 936-632-0074
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Fax | 936-632-0081
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Provider Business Mailing Address
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Address Line | 1111 W FRANK AVE SUITE 303
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City | LUFKIN
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State | TX
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Zip | 75904-3303
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Country | US
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Telephone | 936-632-0074
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Fax | 936-632-0081
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. DAVID T PRICE
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Credential | M.D.
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Telephone | 936-632-0074
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208800000X
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Taxonomy Name | Urology Physician
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License Number | M7537
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License Number State | TX
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