Provider Demographics
NPI:1124135090
Name:DAILY, HERSCHEL B (MD)
Entity type:Individual
Prefix:
First Name:HERSCHEL
Middle Name:B
Last Name:DAILY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 163694
Mailing Address - Street 2:
Mailing Address - City:WEATHERFORD
Mailing Address - State:TX
Mailing Address - Zip Code:76161-3894
Mailing Address - Country:US
Mailing Address - Phone:888-274-9585
Mailing Address - Fax:405-948-6507
Practice Address - Street 1:907 E EUREKA
Practice Address - Street 2:SUITE B
Practice Address - City:WEATHERFORD
Practice Address - State:TX
Practice Address - Zip Code:76086
Practice Address - Country:US
Practice Address - Phone:817-598-9325
Practice Address - Fax:817-599-4902
Is Sole Proprietor?:No
Enumeration Date:2006-08-24
Last Update Date:2008-01-23
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TXE8414207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
C14980Medicare UPIN