Provider Demographics
NPI:1164465563
Name:GEORGE, DAVID WESLEY (MD)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:WESLEY
Last Name:GEORGE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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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:972-234-0813
Practice Address - Street 1:3107 HIGHWAY 71 EAST
Practice Address - Street 2:
Practice Address - City:BASTROP
Practice Address - State:TX
Practice Address - Zip Code:78602
Practice Address - Country:US
Practice Address - Phone:512-308-9024
Practice Address - Fax:512-308-9074
Is Sole Proprietor?:No
Enumeration Date:2006-06-14
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXL4389207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXP00664387OtherRAILROAD MEDICARE
TX8BP226OtherBCBS OF TX
TX154769701Medicaid
TX154769703Medicaid
TX830008309OtherRAILROAD MEDICARE NUMBER
TX8BP226OtherBCBS OF TX
TXP00664387OtherRAILROAD MEDICARE
TXH64375Medicare UPIN
TX8174B7Medicare ID - Type UnspecifiedMEDICARE PROVIDER NUMBER