Provider Demographics
NPI:1851403729
Name:PERSON, DAVID WESLEY (MD)
Entity Type:Individual
Prefix:
First Name:DAVID
Middle Name:WESLEY
Last Name:PERSON
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 1:21 SPURS LN STE 248
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78240-1671
Mailing Address - Country:US
Mailing Address - Phone:210-558-7025
Mailing Address - Fax:210-558-4762
Practice Address - Street 1:21 SPURS LN STE 248
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78240-1671
Practice Address - Country:US
Practice Address - Phone:210-558-7025
Practice Address - Fax:210-558-4762
Is Sole Proprietor?:No
Enumeration Date:2006-08-31
Last Update Date:2023-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXJ95362082S0105X, 208200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208200000XAllopathic & Osteopathic PhysiciansPlastic Surgery
No2082S0105XAllopathic & Osteopathic PhysiciansPlastic SurgerySurgery of the Hand
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX189324001Medicaid
TX189324002Medicaid
TX189324001Medicaid
TX8J4269Medicare Oscar/Certification