Individual
DAVID RYAN WILLINGHAM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1402 W AVENUE H, TEMPLE, TX 76504-5342
(254) 771-8401
(254) 771-8493
Mailing address
1402 W AVENUE H, TEMPLE, TX 76504-5342
(254) 771-8414
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
BP10047348
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
BP10047348
TEXAS MEDICAL BOARD
TX
Enumeration date
04/30/2013
Last updated
02/08/2016
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