Provider Demographics
NPI:1548392517
Name:DOW, DAVID HUBER (OD)
Entity Type:Individual
Prefix:
First Name:DAVID
Middle Name:HUBER
Last Name:DOW
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7308 WOODMONT DR
Mailing Address - Street 2:
Mailing Address - City:AMARILLO
Mailing Address - State:TX
Mailing Address - Zip Code:79119-6409
Mailing Address - Country:US
Mailing Address - Phone:806-353-2238
Mailing Address - Fax:
Practice Address - Street 1:7701 W INTERSTATE 40 STE 296
Practice Address - Street 2:
Practice Address - City:AMARILLO
Practice Address - State:TX
Practice Address - Zip Code:79121-0296
Practice Address - Country:US
Practice Address - Phone:806-352-6800
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX2230T152W00000X, 152WC0802X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered152W00000XEye and Vision Services ProvidersOptometrist
Not Answered152WC0802XEye and Vision Services ProvidersOptometristCorneal and Contact Management
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX918691OtherEYEMED
TX918691OtherEYEMED