Provider Demographics
NPI:1508270539
Name:SON, DAVID (DO, MPH)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:
Last Name:SON
Suffix:
Gender:M
Credentials:DO, MPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7421 MEADOWBROOK DR
Mailing Address - Street 2:
Mailing Address - City:FORT WORTH
Mailing Address - State:TX
Mailing Address - Zip Code:76112-5413
Mailing Address - Country:US
Mailing Address - Phone:817-457-7177
Mailing Address - Fax:
Practice Address - Street 1:7421 MEADOWBROOK DR
Practice Address - Street 2:
Practice Address - City:FORT WORTH
Practice Address - State:TX
Practice Address - Zip Code:76112-5413
Practice Address - Country:US
Practice Address - Phone:817-457-7177
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-06-18
Last Update Date:2023-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXR2982204D00000X, 207RA0401X, 207RA0401X
CA20A17446204D00000X, 207RA0401X
NY286932207RA0401X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RA0401XAllopathic & Osteopathic PhysiciansInternal MedicineAddiction Medicine
No204D00000XAllopathic & Osteopathic PhysiciansNeuromusculoskeletal Medicine & OMM