Provider Demographics
NPI:1265544977
Name:MOSIER, DAVID MICHAEL (MD)
Entity type:Individual
Prefix:DR
First Name:DAVID
Middle Name:MICHAEL
Last Name:MOSIER
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 1:6818 AUSTIN CENTER BLVD
Mailing Address - Street 2:SUITE 206
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78731-3100
Mailing Address - Country:US
Mailing Address - Phone:512-338-4404
Mailing Address - Fax:512-338-4405
Practice Address - Street 1:6818 AUSTIN CENTER BLVD
Practice Address - Street 2:SUITE 206
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78731-3100
Practice Address - Country:US
Practice Address - Phone:512-338-4404
Practice Address - Fax:512-338-4405
Is Sole Proprietor?:No
Enumeration Date:2006-08-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXJ5421208200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208200000XAllopathic & Osteopathic PhysiciansPlastic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX110541302Medicaid
TX00L01XMedicare ID - Type Unspecified
F74143Medicare UPIN