Provider Demographics
NPI:1770526642
Name:WATKINS, DAVID L (MD)
Entity type:Individual
Prefix:DR
First Name:DAVID
Middle Name:L
Last Name:WATKINS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 911230
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75391-1230
Mailing Address - Country:US
Mailing Address - Phone:972-997-8000
Mailing Address - Fax:972-437-9605
Practice Address - Street 1:400 ROSALIND REDFERN GROVER PKWY STE 100
Practice Address - Street 2:
Practice Address - City:MIDLAND
Practice Address - State:TX
Practice Address - Zip Code:79701-5849
Practice Address - Country:US
Practice Address - Phone:326-871-9494
Practice Address - Fax:432-687-4251
Is Sole Proprietor?:No
Enumeration Date:2006-06-14
Last Update Date:2021-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXG0264207RX0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RX0202XAllopathic & Osteopathic PhysiciansInternal MedicineMedical Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NM000L0365Medicaid
TX138244208Medicaid
TX8R1582OtherBLUE CROSS OF TEXAS
TX138244205Medicaid
TX138244215Medicaid
TX8R1582OtherBLUE CROSS OF TEXAS
NM000L0365Medicaid
TX84X652Medicare PIN
TX8R1582OtherBLUE CROSS OF TEXAS
TX8D7998Medicare PIN
TXE29341Medicare UPIN
TX138244215Medicaid