Provider Demographics
NPI:1194730499
Name:WEBB, DONALD DAVID (DC, NP-C)
Entity type:Individual
Prefix:
First Name:DONALD
Middle Name:DAVID
Last Name:WEBB
Suffix:
Gender:M
Credentials:DC, NP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 121
Mailing Address - Street 2:
Mailing Address - City:COPPERAS COVE
Mailing Address - State:TX
Mailing Address - Zip Code:76522-0121
Mailing Address - Country:US
Mailing Address - Phone:254-542-2440
Mailing Address - Fax:254-518-2237
Practice Address - Street 1:1007 W BUS 190
Practice Address - Street 2:SUITE A
Practice Address - City:COPPERAS COVE
Practice Address - State:TX
Practice Address - Zip Code:76522
Practice Address - Country:US
Practice Address - Phone:254-542-2440
Practice Address - Fax:254-518-2237
Is Sole Proprietor?:No
Enumeration Date:2006-07-29
Last Update Date:2020-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP120380363LF0000X
TXDC 7894111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX002043002Medicaid
TX08S4264OtherBCBS
TX08S4264OtherBCBS