Provider Demographics
NPI:1477575215
Name:ADAME, DAVID OMAR (DDS, MS)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:OMAR
Last Name:ADAME
Suffix:
Gender:M
Credentials:DDS, MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:210 W MAHL ST
Mailing Address - Street 2:
Mailing Address - City:EDINBURG
Mailing Address - State:TX
Mailing Address - Zip Code:78539-4331
Mailing Address - Country:US
Mailing Address - Phone:956-381-8262
Mailing Address - Fax:956-381-9193
Practice Address - Street 1:210 W MAHL ST
Practice Address - Street 2:
Practice Address - City:EDINBURG
Practice Address - State:TX
Practice Address - Zip Code:78539-4331
Practice Address - Country:US
Practice Address - Phone:956-381-8262
Practice Address - Fax:956-381-9193
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX123981223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics