Organization
DAVID W THETFORD DO PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DAVID W THETFORD DO (PHYSICIAN/OWNER)
(806) 884-9943
Entity
Organization
Contact information
Practice address
275 CASINO DR, AMARILLO, TX 79118-3816
(806) 884-9943
Mailing address
275 CASINO DR, AMARILLO, TX 79118-3816
(806) 884-9943
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
Enumeration date
03/03/2008
Last updated
04/08/2020
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