Individual
DR. DAVID W VICTOR III
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
6445 MAIN STREET, OPC 22, HOUSTON, TX 77030
(137) 441-4345
Mailing address
6445 MAIN STREET, OPC 22, HOUSTON, TX 77030
(137) 441-4345
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
201516
LA
207RG0100X
Gastroenterology Physician
D0071978
MD
207RG0100X
Gastroenterology Physician
P7593
TX
207RI0008X
Hepatology Physician
P7593
TX
207RT0003X
Transplant Hepatology Physician
Primary
P7593
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
201516
LOUSIANA MEDICAL LISCENSE
LA
01
—
223810ZAEM
MEDICARE
MD
05
—
330482601
—
TX
05
—
330482602
—
TX
05
—
330482603
—
TX
05
—
442244900
—
MD
01
—
8DY375
BLUE CROSS BLUE SHIELD
TX
01
—
D0071978
MD MEDICAL LICENSE
MD
01
—
P01707725
RR MEDICARE
TX
Enumeration date
11/28/2007
Last updated
09/14/2018
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