Provider Demographics
NPI:1427095603
Name:ENGLEMAN, DAVID A (MD)
Entity type:Individual
Prefix:
First Name:DAVID
Middle Name:A
Last Name:ENGLEMAN
Suffix:
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 1:6161 N STATE HIGHWAY 161
Mailing Address - Street 2:
Mailing Address - City:IRVING
Mailing Address - State:TX
Mailing Address - Zip Code:75038-2220
Mailing Address - Country:US
Mailing Address - Phone:972-258-7499
Mailing Address - Fax:972-257-0897
Practice Address - Street 1:6161 N HIGHWAY 161
Practice Address - Street 2:
Practice Address - City:IRVING
Practice Address - State:TX
Practice Address - Zip Code:75038
Practice Address - Country:US
Practice Address - Phone:972-258-7499
Practice Address - Fax:972-257-0897
Is Sole Proprietor?:No
Enumeration Date:2006-05-31
Last Update Date:2018-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXJ7947207R00000X, 207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXJ7947OtherLICENSE
TX3321505OtherBLUE LINK
TXP00264559OtherRR MCARE
TX141239706Medicaid
TXP00264559OtherRR MCARE
TX141239707Medicaid
TX141239708Medicaid
TX3321505OtherBLUE LINK
TXP00264559OtherRR MCARE
F21505Medicare UPIN
TX8D4702Medicare ID - Type Unspecified
TX8L7844Medicare PIN
TX141239707Medicaid
TX8L7864Medicare PIN