Provider Demographics
NPI:1093785404
Name:DELLINGER, DAVID BRIAN (DO)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:BRIAN
Last Name:DELLINGER
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 1:11623 ANGUS RD
Mailing Address - Street 2:SUITE C15
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78759-4003
Mailing Address - Country:US
Mailing Address - Phone:512-229-1978
Mailing Address - Fax:512-402-5409
Practice Address - Street 1:11623 ANGUS RD
Practice Address - Street 2:SUITE C15
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78759-4003
Practice Address - Country:US
Practice Address - Phone:512-229-1978
Practice Address - Fax:512-229-1978
Is Sole Proprietor?:Yes
Enumeration Date:2006-01-26
Last Update Date:2016-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH34005727208200000X
TXH7994207Q00000X, 2086S0122X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086S0122XAllopathic & Osteopathic PhysiciansSurgeryPlastic and Reconstructive Surgery
No208200000XAllopathic & Osteopathic PhysiciansPlastic Surgery
No207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2022822Medicaid
OHE51570Medicare UPIN
OHDE0831253Medicare PIN