Individual
DR. DAVID BARRY WILLINGHAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
4222 WENDOVER AVE, SUITE 600, ODESSA, TX 79762-5945
(432) 552-5656
(432) 552-0992
Mailing address
4222 WENDOVER AVE, SUITE 600, ODESSA, TX 79762-5945
(432) 552-5656
(432) 552-0992
Taxonomy
Speciality
Code
Description
License number
State
207QA0505X
Adult Medicine Physician
Primary
H9047
TX
208D00000X
General Practice Physician
H0947
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
8J3983
BCBS PROVIDER NUMBER
TX
01
—
H0947
TX LICENSE NUMBER
TX
Enumeration date
10/19/2005
Last updated
07/02/2010
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