Provider Demographics
NPI:1295744035
Name:MOREHEAD, DAVID BYRON (DO)
Entity type:Individual
Prefix:DR
First Name:DAVID
Middle Name:BYRON
Last Name:MOREHEAD
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5933 E FM 875
Mailing Address - Street 2:
Mailing Address - City:WAXAHACHIE
Mailing Address - State:TX
Mailing Address - Zip Code:75167-8156
Mailing Address - Country:US
Mailing Address - Phone:972-938-3685
Mailing Address - Fax:972-937-5608
Practice Address - Street 1:1505 W JEFFERSON ST
Practice Address - Street 2:SUITE 120
Practice Address - City:WAXAHACHIE
Practice Address - State:TX
Practice Address - Zip Code:75165-2277
Practice Address - Country:US
Practice Address - Phone:972-938-3493
Practice Address - Fax:972-937-5608
Is Sole Proprietor?:No
Enumeration Date:2006-08-07
Last Update Date:2014-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXJ4373207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXJ4373OtherSTATE MEDICAL
TX096756403Medicaid
TX00229ZOtherMEDICARE GROUP
TX00229ZOtherMEDICARE GROUP
TX8F0744Medicare ID - Type Unspecified