Provider Demographics
NPI:1801874763
Name:SECORD, DAVID JOHN (DPM)
Entity type:Individual
Prefix:DR
First Name:DAVID
Middle Name:JOHN
Last Name:SECORD
Suffix:
Gender:M
Credentials:DPM
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Mailing Address - Street 1:5350 S STAPLES ST
Mailing Address - Street 2:SUITE 100
Mailing Address - City:CORPUS CHRISTI
Mailing Address - State:TX
Mailing Address - Zip Code:78411-4682
Mailing Address - Country:US
Mailing Address - Phone:361-888-8878
Mailing Address - Fax:361-888-8815
Practice Address - Street 1:801 W 1ST ST
Practice Address - Street 2:
Practice Address - City:SAN JUAN
Practice Address - State:TX
Practice Address - Zip Code:78589-2276
Practice Address - Country:US
Practice Address - Phone:956-787-8915
Practice Address - Fax:956-787-2021
Is Sole Proprietor?:No
Enumeration Date:2006-01-02
Last Update Date:2024-03-21
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Provider Licenses
StateLicense IDTaxonomies
TX1412213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX038897704Medicaid
TXP01362501OtherRAILROAD MEDICARE
TX8L16634Medicare PIN
TX038897704Medicaid
TXP01362501OtherRAILROAD MEDICARE