Provider Demographics
NPI:1588767834
Name:C DAVID GARVIN, MD, PA
Entity type:Organization
Organization Name:C DAVID GARVIN, MD, PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:
Authorized Official - First Name:C
Authorized Official - Middle Name:DAVID
Authorized Official - Last Name:GARVIN
Authorized Official - Suffix:
Authorized Official - Credentials:M D
Authorized Official - Phone:903-463-8448
Mailing Address - Street 1:1300 HWY 91 N
Mailing Address - Street 2:
Mailing Address - City:DENISON
Mailing Address - State:TX
Mailing Address - Zip Code:75020
Mailing Address - Country:US
Mailing Address - Phone:903-463-8448
Mailing Address - Fax:903-463-7358
Practice Address - Street 1:1300 HWY 91 N
Practice Address - Street 2:
Practice Address - City:DENISON
Practice Address - State:TX
Practice Address - Zip Code:75020
Practice Address - Country:US
Practice Address - Phone:903-463-8448
Practice Address - Fax:903-463-7358
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-05
Last Update Date:2011-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXPA03416363AM0700X
TXF9469174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Multi-Specialty
No363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedicalGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX098392603Medicaid
TX8A1547Medicare UPIN
TX8A1548Medicare UPIN
TXB90207Medicare UPIN
TX098392603Medicaid