Provider Demographics
NPI:1881862357
Name:TOBIAS, DAVID (MD)
Entity Type:Individual
Prefix:
First Name:DAVID
Middle Name:
Last Name:TOBIAS
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 1:4800 HEDGCOXE RD
Mailing Address - Street 2:SUITE 200
Mailing Address - City:PLANO
Mailing Address - State:TX
Mailing Address - Zip Code:75024-2401
Mailing Address - Country:US
Mailing Address - Phone:972-860-8750
Mailing Address - Fax:972-860-8757
Practice Address - Street 1:4800 HEDGCOXE RD
Practice Address - Street 2:SUITE 200
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75024-2401
Practice Address - Country:US
Practice Address - Phone:972-860-8750
Practice Address - Fax:972-860-8757
Is Sole Proprietor?:No
Enumeration Date:2008-02-18
Last Update Date:2011-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXBP1-0028452207Q00000X
TXN7593207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX8CN325OtherBCBSTX
TX219210601Medicaid
TXTXB117729Medicare PIN