Provider Demographics
NPI:1346236841
Name:OSTERMAN, DAVID W (MD PA)
Entity type:Individual
Prefix:
First Name:DAVID
Middle Name:W
Last Name:OSTERMAN
Suffix:
Gender:M
Credentials:MD PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:403 N HIGHLAND AVE
Mailing Address - Street 2:
Mailing Address - City:SHERMAN
Mailing Address - State:TX
Mailing Address - Zip Code:75092-7351
Mailing Address - Country:US
Mailing Address - Phone:903-892-3696
Mailing Address - Fax:903-893-9514
Practice Address - Street 1:403 N HIGHLAND AVE
Practice Address - Street 2:
Practice Address - City:SHERMAN
Practice Address - State:TX
Practice Address - Zip Code:75092-7351
Practice Address - Country:US
Practice Address - Phone:903-892-3696
Practice Address - Fax:903-893-9514
Is Sole Proprietor?:No
Enumeration Date:2005-09-21
Last Update Date:2011-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXF9907207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX120343203Medicaid
TXB25309Medicare UPIN
TX120343203Medicaid
TX0712000001Medicare NSC