Provider Demographics
NPI:1932103918
Name:TEXADA, DAVID SPENCE (MD)
Entity Type:Individual
Prefix:
First Name:DAVID
Middle Name:SPENCE
Last Name:TEXADA
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 1:3901 HOUMA BLVD STE 108
Mailing Address - Street 2:
Mailing Address - City:METAIRIE
Mailing Address - State:LA
Mailing Address - Zip Code:70006-2930
Mailing Address - Country:US
Mailing Address - Phone:504-779-3507
Mailing Address - Fax:504-779-3508
Practice Address - Street 1:3901 HOUMA BLVD STE 108
Practice Address - Street 2:
Practice Address - City:METAIRIE
Practice Address - State:LA
Practice Address - Zip Code:70006-2930
Practice Address - Country:US
Practice Address - Phone:504-779-3507
Practice Address - Fax:504-779-3508
Is Sole Proprietor?:No
Enumeration Date:2005-06-08
Last Update Date:2021-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAMD.026746207QA0505X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207QA0505XAllopathic & Osteopathic PhysiciansFamily MedicineAdult Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1162612Medicaid
LAH95155Medicare UPIN
LA5CG96Medicare ID - Type Unspecified