Provider Demographics
NPI:1649251497
Name:HERRMANN, DAVID R (MD)
Entity type:Individual
Prefix:
First Name:DAVID
Middle Name:R
Last Name:HERRMANN
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Gender:M
Credentials:MD
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Mailing Address - Street 1:601 OMEGA DR
Mailing Address - Street 2:SUITE 206
Mailing Address - City:ARLINGTON
Mailing Address - State:TX
Mailing Address - Zip Code:76014-2075
Mailing Address - Country:US
Mailing Address - Phone:817-465-5881
Mailing Address - Fax:817-465-6336
Practice Address - Street 1:4375 BOOTH CALLOWAY RD
Practice Address - Street 2:STE 307
Practice Address - City:NORTH RICHLAND HILLS
Practice Address - State:TX
Practice Address - Zip Code:76180-8362
Practice Address - Country:US
Practice Address - Phone:817-284-4343
Practice Address - Fax:817-590-4393
Is Sole Proprietor?:No
Enumeration Date:2005-11-09
Last Update Date:2014-08-26
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Provider Licenses
StateLicense IDTaxonomies
TXJ5349207RC0200X, 207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
No207RC0200XAllopathic & Osteopathic PhysiciansInternal MedicineCritical Care Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX100610802Medicaid
E48735Medicare UPIN
TX80195KMedicare PIN