Provider Demographics
NPI:1205832367
Name:WALKER, DAVID G (MD)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:G
Last Name:WALKER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 11785
Mailing Address - Street 2:
Mailing Address - City:BELFAST
Mailing Address - State:ME
Mailing Address - Zip Code:04915-4008
Mailing Address - Country:US
Mailing Address - Phone:713-776-2200
Mailing Address - Fax:713-776-2211
Practice Address - Street 1:8408 BELLAIRE BLVD
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77036-4702
Practice Address - Country:US
Practice Address - Phone:713-776-2200
Practice Address - Fax:713-776-2211
Is Sole Proprietor?:Yes
Enumeration Date:2005-06-23
Last Update Date:2017-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXG3884207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX096795205Medicaid
TX8AJ504OtherBLUE CROSS BLUE SHIELD
TX096795202Medicaid
TN096795204Medicaid
TN096795204Medicaid
TX096795205Medicaid