Provider Demographics
NPI:1205338423
Name:FANSLER, DAVID FANSLER
Entity type:Individual
Prefix:MR
First Name:DAVID
Middle Name:FANSLER
Last Name:FANSLER
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4314 S HAYDEN ST
Mailing Address - Street 2:
Mailing Address - City:AMARILLO
Mailing Address - State:TX
Mailing Address - Zip Code:79110-2006
Mailing Address - Country:US
Mailing Address - Phone:806-683-2991
Mailing Address - Fax:
Practice Address - Street 1:4314 S HAYDEN ST
Practice Address - Street 2:
Practice Address - City:AMARILLO
Practice Address - State:TX
Practice Address - Zip Code:79110-2006
Practice Address - Country:US
Practice Address - Phone:806-683-2991
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-03-03
Last Update Date:2018-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant