Provider Demographics
NPI:1881247203
Name:WEBB, DAVID CHARLES
Entity type:Individual
Prefix:
First Name:DAVID
Middle Name:CHARLES
Last Name:WEBB
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 1:4706 N MIDKIFF RD
Mailing Address - Street 2:
Mailing Address - City:MIDLAND
Mailing Address - State:TX
Mailing Address - Zip Code:79705-2564
Mailing Address - Country:US
Mailing Address - Phone:432-699-7578
Mailing Address - Fax:432-694-7312
Practice Address - Street 1:4706 N MIDKIFF RD
Practice Address - Street 2:
Practice Address - City:MIDLAND
Practice Address - State:TX
Practice Address - Zip Code:79705-2564
Practice Address - Country:US
Practice Address - Phone:432-699-7578
Practice Address - Fax:432-694-7312
Is Sole Proprietor?:No
Enumeration Date:2019-07-24
Last Update Date:2019-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX19811183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist