Provider Demographics
NPI:1184801268
Name:BAPTISTE, DAVID J (OD)
Entity type:Individual
Prefix:DR
First Name:DAVID
Middle Name:J
Last Name:BAPTISTE
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:4724 MONTANA AVE
Mailing Address - Street 2:
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79903-4811
Mailing Address - Country:US
Mailing Address - Phone:915-566-8693
Mailing Address - Fax:915-566-9229
Practice Address - Street 1:4724 MONTANA AVE
Practice Address - Street 2:
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79903-4811
Practice Address - Country:US
Practice Address - Phone:915-566-8693
Practice Address - Fax:915-566-9229
Is Sole Proprietor?:No
Enumeration Date:2008-01-30
Last Update Date:2018-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV895152W00000X
LA1215-386T152W00000X
TN3331152W00000X
IN18004006A152W00000X
NYTUV008541-1152W00000X
TX6879 T152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA4B226Medicare PIN