Provider Demographics
NPI:1003183484
Name:PURTLE, DAVID L (MD)
Entity Type:Individual
Prefix:
First Name:DAVID
Middle Name:L
Last Name:PURTLE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:4438 CENTERVIEW
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78228-1440
Mailing Address - Country:US
Mailing Address - Phone:210-280-0040
Mailing Address - Fax:210-280-0060
Practice Address - Street 1:1921 LOHMANS CROSSING RD STE 150
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78734-5386
Practice Address - Country:US
Practice Address - Phone:737-717-8430
Practice Address - Fax:737-717-8469
Is Sole Proprietor?:Yes
Enumeration Date:2011-11-29
Last Update Date:2019-10-15
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
TXQ5907207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX3517526-01OtherWELLMED MEDICAID
TX448420YLPSOtherWELLMED MEDICARE