Provider Demographics
NPI:1992808018
Name:WEBSTER, DAVE E (DO)
Entity type:Individual
Prefix:
First Name:DAVE
Middle Name:E
Last Name:WEBSTER
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 2909
Mailing Address - Street 2:
Mailing Address - City:HARKER HEIGHTS
Mailing Address - State:TX
Mailing Address - Zip Code:76548
Mailing Address - Country:US
Mailing Address - Phone:254-690-8887
Mailing Address - Fax:254-690-6696
Practice Address - Street 1:5610 E CENTRAL TEXAS EXPY STE 1
Practice Address - Street 2:
Practice Address - City:KILLEEN
Practice Address - State:TX
Practice Address - Zip Code:76543-5600
Practice Address - Country:US
Practice Address - Phone:254-690-8887
Practice Address - Fax:254-690-6696
Is Sole Proprietor?:No
Enumeration Date:2006-09-06
Last Update Date:2014-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXE5982207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
080167798OtherRAILROAD MEDICARE
TX136444006Medicaid
A67772Medicare UPIN
080167798OtherRAILROAD MEDICARE
TX00593GMedicare PIN