Individual
DAVID MEIUM LARSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PNP
Contact information
Practice address
2200 BERGQUIST DR, WILFORD HALL MEDICAL CENTER, 8C/MMNP, LACKLAND A F B, TX 78236-9907
(210) 292-6248
(210) 292-7902
Mailing address
PO BOX 27585, VALLEY HI POST OFFICE, SAN ANTONIO, TX 78227-0585
(210) 292-6248
(210) 292-7902
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
708931
TX
Other
Enumeration date
01/06/2006
Last updated
05/06/2016
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