Provider Demographics
NPI:1912053232
Name:SAUCEDA, DAVID III (MD)
Entity type:Individual
Prefix:DR
First Name:DAVID
Middle Name:
Last Name:SAUCEDA
Suffix:III
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 1:2226 HAINE DR
Mailing Address - Street 2:
Mailing Address - City:HARLINGEN
Mailing Address - State:TX
Mailing Address - Zip Code:78550-8549
Mailing Address - Country:US
Mailing Address - Phone:956-423-1283
Mailing Address - Fax:956-412-3033
Practice Address - Street 1:2226 HAINE DR
Practice Address - Street 2:
Practice Address - City:HARLINGEN
Practice Address - State:TX
Practice Address - Zip Code:78550-8549
Practice Address - Country:US
Practice Address - Phone:956-423-1283
Practice Address - Fax:956-412-3033
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-27
Last Update Date:2024-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXM4513208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX092695803Medicaid
TX093756701Medicaid
TX187365506Medicaid
TX187365509Medicaid
TX092695805Medicaid
TX092695806Medicaid
TX187365508Medicaid