| David W Carlson Md Pa | |
|
4402 Broadway Blvd Suite 1 Garland TX 75043-8263 | |
| (972) 240-1789 | |
| Not Available |
| Full Name | David W Carlson Md Pa |
|---|---|
| Speciality | Clinic/Center |
| Location | 4402 Broadway Blvd, Garland, Texas |
| Authorized Official Name and Position | Sylvia Carlson (BUSINESS MANAGER) |
| Authorized Official Contact | 9722401789 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| David W Carlson Md Pa 4402 Broadway Blvd Suite 1 Garland TX 75043-8263 Ph: (972) 240-1789 | David W Carlson Md Pa 4402 Broadway Blvd Suite 1 Garland TX 75043-8263 Ph: (972) 240-1789 |
| NPI Number | 1356768006 |
|---|---|
| Provider Enumeration Date | 03/19/2014 |
| Last Update Date | 03/19/2014 |
| Medicare PECOS PAC ID | 9830322809 |
|---|---|
| Medicare Enrollment ID | O20140428000482 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1356768006 | NPI | - | NPPES |
| 1700961406 | Other | TX | NPI |
| C14201 | Other | TX | UPIN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | HO233 (Texas) | Primary |
| Provider Name | David Carlson |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1700961406 PECOS PAC ID: 0749270858 Enrollment ID: I20040512001085 |
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