NPIMap

Individual provider Active NPI

David Crockett Teller, MD

  • Facial Plastic Surgery Physician
  • Austin, TX
National Provider Identifier
1154300788
Registry record updated Dec 15, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Facial Plastic Surgery PhysicianTaxonomy code 207YS0123X
License
H2828 Issued in TX
Practice address
7901 Metropolis Dr
Austin, TX 78744-3111
Phone
(512) 823-4880
Fax
(512) 823-4155
NPI assigned
Jan 12, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 15, 2016

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Facial Plastic Surgery Physician 207YS0123X H2828 TX Primary

Addresses

Primary practice location

7901 Metropolis Dr
Austin, TX 78744-3111

Mailing address

7901 Metropolis Dr
Austin, TX 78744-3111
Phone (512) 823-4880

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
South Texas Medical Clinics, P.a. Past Accepting new patients
Utmb Faculty Group Practice Past Accepting new patients
St Joseph Physician Associates Past Accepting new patients
South Texas Medical Clinics, P.a. Past Accepting new patients

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1137024000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1481760000000",
    "number": "1154300788",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7901 METROPOLIS DR",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787443111",
            "telephone_number": "512-823-4880",
            "fax_number": "512-823-4155"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7901 METROPOLIS DR",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787443111",
            "telephone_number": "512-823-4880",
            "fax_number": "512-823-4155"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TELLER",
        "first_name": "DAVID",
        "middle_name": "CROCKETT",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-12",
        "last_updated": "2016-12-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207YS0123X",
            "taxonomy_group": "",
            "desc": "Otolaryngology, Facial Plastic Surgery",
            "state": "TX",
            "license": "H2828",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Austin, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 15, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.