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Individual

DAVID T LARSEN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
3000 CORPORATE CT, SUITE 400, FLOWER MOUND, TX 75028-2299
(214) 647-6165
(214) 647-6166
Mailing address
3000 CORPORATE CT, SUITE 400, FLOWER MOUND, TX 75028-2299
(214) 647-6165
(214) 647-6166

Taxonomy

Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
F9711
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
138590810
TX
Enumeration date
07/19/2005
Last updated
08/02/2010
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