Provider Demographics
NPI:1346355203
Name:TALAFUSE, DAVID WAYNE (MD)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:WAYNE
Last Name:TALAFUSE
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:11901 TOEPPERWEIN RD
Mailing Address - Street 2:SUITE 1201
Mailing Address - City:LIVE OAK
Mailing Address - State:TX
Mailing Address - Zip Code:78233-3161
Mailing Address - Country:US
Mailing Address - Phone:210-650-9066
Mailing Address - Fax:210-650-9067
Practice Address - Street 1:11901 TOEPPERWEIN RD
Practice Address - Street 2:SUITE 1201
Practice Address - City:LIVE OAK
Practice Address - State:TX
Practice Address - Zip Code:78233-3161
Practice Address - Country:US
Practice Address - Phone:210-650-9066
Practice Address - Fax:210-650-9067
Is Sole Proprietor?:No
Enumeration Date:2006-08-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TXH0869207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX8P1540OtherBLUE CROSS
TX8P1540OtherBLUE CROSS
TX8C2060Medicare ID - Type Unspecified