Provider Demographics
NPI:1902978133
Name:HIME, DAVID LLOYD (DDS)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:LLOYD
Last Name:HIME
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5718 BALCONES DR
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78731-4204
Mailing Address - Country:US
Mailing Address - Phone:512-458-4103
Mailing Address - Fax:512-458-5535
Practice Address - Street 1:5718 BALCONES DR
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78731-4204
Practice Address - Country:US
Practice Address - Phone:512-458-4103
Practice Address - Fax:512-458-5535
Is Sole Proprietor?:No
Enumeration Date:2006-11-14
Last Update Date:2022-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX151651223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics
Provider Identifiers
StateIdentifier IDID TypeIssuer
1630514OtherUNITED CONCORDIA
88D696OtherBLUE CROSS BLUE SHIELD