Provider Demographics
NPI:1376692285
Name:CHOI, DAVID J (MD)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:J
Last Name:CHOI
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 1:4551 WESTERN CENTER BLVD
Mailing Address - Street 2:
Mailing Address - City:FORT WORTH
Mailing Address - State:TX
Mailing Address - Zip Code:76137-2628
Mailing Address - Country:US
Mailing Address - Phone:817-644-3340
Mailing Address - Fax:817-644-3344
Practice Address - Street 1:4551 WESTERN CENTER BLVD
Practice Address - Street 2:
Practice Address - City:FORT WORTH
Practice Address - State:TX
Practice Address - Zip Code:76137-2628
Practice Address - Country:US
Practice Address - Phone:817-644-3340
Practice Address - Fax:817-644-3344
Is Sole Proprietor?:No
Enumeration Date:2007-01-09
Last Update Date:2015-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK24109207Q00000X
TXN1285207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXP00802535OtherRAILROAD
TX198466802Medicaid
TX8L19569Medicare PIN