Provider Demographics
NPI:1740210319
Name:HILDRETH, DAVID (MD)
Entity Type:Individual
Prefix:
First Name:DAVID
Middle Name:
Last Name:HILDRETH
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 1:909 FROSTWOOD DR
Mailing Address - Street 2:SUITE 1.100
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77024-2301
Mailing Address - Country:US
Mailing Address - Phone:281-344-1715
Mailing Address - Fax:
Practice Address - Street 1:21660 KINGSLAND BLVD
Practice Address - Street 2:SUITE 200
Practice Address - City:KATY
Practice Address - State:TX
Practice Address - Zip Code:77450
Practice Address - Country:US
Practice Address - Phone:713-493-7777
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-03
Last Update Date:2023-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXG7230207XS0106X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207XS0106XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryHand Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX127857414Medicaid
TXP00638114OtherRR MEDICARE
TX127857412Medicaid
TX613410OtherMEDICARE SOLO PTAN
UT8L1102OtherMEDICARE PTAN-RBJC
TX127857411Medicaid
TX127857413Medicaid
TX8BE721OtherBLUE CROSS BLUE SHIELD
TXP01026737OtherRAILROAD MEDICARE
TX127857412Medicaid
TX127857411Medicaid
TXTXB143676Medicare PIN
TXTXB143697Medicare PIN
TX8BE721OtherBLUE CROSS BLUE SHIELD