Basic Information
Provider Information
NPI: 1922435759
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: WARD
FirstName: DAVID
MiddleName:  
NamePrefix: MR.
NameSuffix:  
Credential: FNP
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 7000 N MOPAC
Address2: SUITE 420
City: AUSTIN
State: TX
PostalCode: 787313027
CountryCode: US
TelephoneNumber: 5124820045
FaxNumber: 5124769892
Practice Location
Address1: 7000 N MOPAC
Address2: SUITE 420
City: AUSTIN
State: TX
PostalCode: 787313027
CountryCode: US
TelephoneNumber: 5124820045
FaxNumber: 5124769892
Other Information
ProviderEnumerationDate: 10/11/2013
LastUpdateDate: 06/17/2014
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
363LF0000X800688TXY Physician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily

No ID Information.


Home