Provider Demographics
NPI:1225078991
Name:LAMASTERS, DAVID LOGAN (MD)
Entity Type:Individual
Prefix:
First Name:DAVID
Middle Name:LOGAN
Last Name:LAMASTERS
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 1:5323 HARBOR TOWN DR
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75287-7320
Mailing Address - Country:US
Mailing Address - Phone:972-612-0423
Mailing Address - Fax:
Practice Address - Street 1:3700 W 15TH ST
Practice Address - Street 2:BUILDING D SUITE 100
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75075-4736
Practice Address - Country:US
Practice Address - Phone:972-612-0523
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXG75442085N0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085N0700XAllopathic & Osteopathic PhysiciansRadiologyNeuroradiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
A48715Medicare UPIN