Provider Demographics
NPI:1316935166
Name:ROSS, DAVID M JR (MD)
Entity type:Individual
Prefix:
First Name:DAVID
Middle Name:M
Last Name:ROSS
Suffix:JR
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7922 EWING HALSELL DR
Mailing Address - Street 2:SUITE 440
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78229-3786
Mailing Address - Country:US
Mailing Address - Phone:210-614-2500
Mailing Address - Fax:210-614-2755
Practice Address - Street 1:7922 EWING HALSELL DR
Practice Address - Street 2:SUITE 440
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78229-3786
Practice Address - Country:US
Practice Address - Phone:210-614-2500
Practice Address - Fax:210-614-2755
Is Sole Proprietor?:Yes
Enumeration Date:2005-10-06
Last Update Date:2011-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXL3805208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics