Provider Demographics
NPI:1508848052
Name:HOERSTER, DAN DAVID (MD)
Entity Type:Individual
Prefix:
First Name:DAN
Middle Name:DAVID
Last Name:HOERSTER
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:PO BOX 844658
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75284-4658
Mailing Address - Country:US
Mailing Address - Phone:800-994-0371
Mailing Address - Fax:254-215-9722
Practice Address - Street 1:102 E YOUNG ST
Practice Address - Street 2:
Practice Address - City:LLANO
Practice Address - State:TX
Practice Address - Zip Code:78643-1349
Practice Address - Country:US
Practice Address - Phone:325-247-4131
Practice Address - Fax:325-248-2099
Is Sole Proprietor?:No
Enumeration Date:2005-11-18
Last Update Date:2022-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXF1652207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX92915OtherSCOTT WHITE
TX115241101OtherFIRSTCARE
TX138253304Medicaid
TX83012KOtherBCBS
TX138253309Medicaid
TX482808892OtherTRICARE
TX83004KMedicare PIN
TX83012KMedicare PIN
TX115241101OtherFIRSTCARE
TX138253309Medicaid