Organization
DR. DAVID D. LONG M.D., P.A.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DAVID DEAN LONG M.D. (OWNER)
(432) 714-4650
Entity
Organization
Contact information
Practice address
910 S MAIN ST, BIG SPRING, TX 79720-2928
(432) 714-4650
(432) 714-4653
Mailing address
910 S MAIN ST, BIG SPRING, TX 79720-2928
(432) 714-4650
(432) 714-4653
Taxonomy
Speciality
Code
Description
License number
State
305R00000X
Preferred Provider Organization
Primary
H0574
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0059QP
BLUE CROSS BLUE SHIELD
TX
01
—
DE4229
RAILROAD
TX
Enumeration date
10/13/2006
Last updated
05/27/2008
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