Provider Demographics
NPI:1861494924
Name:DAVID, ELBERT R (MD)
Entity Type:Individual
Prefix:DR
First Name:ELBERT
Middle Name:R
Last Name:DAVID
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:7200 WYOMING SPGS
Mailing Address - Street 2:STE 600
Mailing Address - City:ROUND ROCK
Mailing Address - State:TX
Mailing Address - Zip Code:78681-4305
Mailing Address - Country:US
Mailing Address - Phone:512-244-1995
Mailing Address - Fax:512-244-2090
Practice Address - Street 1:7200 WYOMING SPGS
Practice Address - Street 2:STE 600
Practice Address - City:ROUND ROCK
Practice Address - State:TX
Practice Address - Zip Code:78681-4305
Practice Address - Country:US
Practice Address - Phone:512-244-1995
Practice Address - Fax:512-244-2090
Is Sole Proprietor?:Yes
Enumeration Date:2005-06-02
Last Update Date:2010-07-12
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TXG3272207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX4268528OtherERD AETNA PPO
TX86V630OtherERD BLUE HMO
TX4268528OtherERD AETNA HMO
TX7722675006OtherERD CIGNA PPO
TX7722675005OtherERD CIGNA HMO
TX86V630OtherERD OLD HMO BLUE
TX86V630OtherERD BLUE PPO
TX123211802Medicaid
TX758630OtherERD FH PPO
TX123211802Medicaid
TX7722675006OtherERD CIGNA PPO