Provider Demographics
NPI:1477658482
Name:PFEIFER, DAVID PATRIC (FNP)
Entity Type:Individual
Prefix:MR
First Name:DAVID
Middle Name:PATRIC
Last Name:PFEIFER
Suffix:
Gender:M
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:305 LIMESTONE TER STE C-3
Mailing Address - Street 2:
Mailing Address - City:JARRELL
Mailing Address - State:TX
Mailing Address - Zip Code:76537-1293
Mailing Address - Country:US
Mailing Address - Phone:512-588-1501
Mailing Address - Fax:855-346-7410
Practice Address - Street 1:305 LIMESTONE TER STE C-3
Practice Address - Street 2:
Practice Address - City:JARRELL
Practice Address - State:TX
Practice Address - Zip Code:76537-1293
Practice Address - Country:US
Practice Address - Phone:512-588-1501
Practice Address - Fax:855-346-7410
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-14
Last Update Date:2022-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP113910363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ422986Medicaid