Individual
DR. DAVID THETFORD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
275 CASINO DR, AMARILLO, TX 79118-3816
(806) 884-9943
Mailing address
206 E 16TH ST, DALHART, TX 79022-4802
(806) 244-5668
(806) 244-5912
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
L5585
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
155206901
—
TX
01
—
8A5753
BLUE CROSS/BLUE SHIELD
TX
Enumeration date
10/02/2006
Last updated
04/08/2020
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