Provider Demographics
NPI:1417932120
Name:TERRESON, DAVID W (MD)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:W
Last Name:TERRESON
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:5301 RIATA PARK CT
Mailing Address - Street 2:BLDG D SUITE 200
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78727-3437
Mailing Address - Country:US
Mailing Address - Phone:512-617-6000
Mailing Address - Fax:512-615-0459
Practice Address - Street 1:1301 W 38TH ST
Practice Address - Street 2:SUITE 705
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78705-1000
Practice Address - Country:US
Practice Address - Phone:512-617-6000
Practice Address - Fax:512-680-0766
Is Sole Proprietor?:No
Enumeration Date:2005-12-14
Last Update Date:2022-02-09
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
TXH2830207RI0011X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0011XAllopathic & Osteopathic PhysiciansInternal MedicineInterventional Cardiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX042868201Medicaid
TX060062655OtherMEDICARE RAILROAD
TX042868201Medicaid
TX060062655OtherMEDICARE RAILROAD
TX8L14547Medicare PIN
TX8L14977Medicare PIN