Provider Demographics
NPI:1225259302
Name:CARDWELL, DAVID WILLIAMS (MD)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:WILLIAMS
Last Name:CARDWELL
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 1:800 W 34TH ST
Mailing Address - Street 2:SUITE #210
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78705-1143
Mailing Address - Country:US
Mailing Address - Phone:512-454-0326
Mailing Address - Fax:512-454-0055
Practice Address - Street 1:800 W 34TH ST
Practice Address - Street 2:SUITE #210
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78705-1143
Practice Address - Country:US
Practice Address - Phone:512-454-0326
Practice Address - Fax:512-454-0055
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXE24992084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
00JP98Medicare ID - Type Unspecified
TXB21693Medicare UPIN