Provider Demographics
NPI:1427395391
Name:WESTFALL, DAVID THOMAS
Entity type:Individual
Prefix:
First Name:DAVID
Middle Name:THOMAS
Last Name:WESTFALL
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1815 CENTRAL AVE NW
Mailing Address - Street 2:
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87104-1143
Mailing Address - Country:US
Mailing Address - Phone:505-247-4141
Mailing Address - Fax:505-843-6249
Practice Address - Street 1:1815 CENTRAL AVE NW
Practice Address - Street 2:
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87104-1143
Practice Address - Country:US
Practice Address - Phone:505-247-4141
Practice Address - Fax:505-843-6249
Is Sole Proprietor?:No
Enumeration Date:2013-01-11
Last Update Date:2025-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMRP00009503183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist