Provider Demographics
NPI:1629006853
Name:WATKINS, DAVID L (MD)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:L
Last Name:WATKINS
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 1:3600 GASTON AVE
Mailing Address - Street 2:BARNETT TOWER, SUITE 707
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75246-1800
Mailing Address - Country:US
Mailing Address - Phone:214-823-6492
Mailing Address - Fax:214-818-9180
Practice Address - Street 1:3600 GASTON AVE
Practice Address - Street 2:WADLEY TOWER, SUITE 261
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75246-1800
Practice Address - Country:US
Practice Address - Phone:214-818-9100
Practice Address - Fax:214-818-9180
Is Sole Proprietor?:No
Enumeration Date:2006-06-28
Last Update Date:2010-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXG4742207ZP0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical Pathology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX81P037OtherBLUE CROSS BLUE SHIELD
TX220018979OtherRAILROAD MEDICARE
TX138244210Medicaid
TX81P037OtherBLUE CROSS BLUE SHIELD
TX220018979OtherRAILROAD MEDICARE