Provider Demographics
NPI:1366611261
Name:O'DELL, DAVID MELTON (MD, JD)
Entity type:Individual
Prefix:DR
First Name:DAVID
Middle Name:MELTON
Last Name:O'DELL
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Gender:M
Credentials:MD, JD
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Mailing Address - Street 1:1100 W REYNOSA AVE
Mailing Address - Street 2:
Mailing Address - City:DE LEON
Mailing Address - State:TX
Mailing Address - Zip Code:76444-1630
Mailing Address - Country:US
Mailing Address - Phone:254-893-5895
Mailing Address - Fax:254-893-5222
Practice Address - Street 1:3804 HIGHWAY 377 S
Practice Address - Street 2:
Practice Address - City:BROWNWOOD
Practice Address - State:TX
Practice Address - Zip Code:76801-5120
Practice Address - Country:US
Practice Address - Phone:325-643-5167
Practice Address - Fax:325-641-1856
Is Sole Proprietor?:Yes
Enumeration Date:2008-02-25
Last Update Date:2014-12-30
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Provider Licenses
StateLicense IDTaxonomies
TXE1093208D00000X, 207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
No207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXE1093OtherLICENSE