Individual provider Active NPI

David M Wild, M.D.

  • Anesthesiology Physician
  • Fredericksburg, TX
National Provider Identifier
1164628418
Registry record updated Dec 1, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
W1713 Issued in TX
Practice address
811 S Milam St
Fredericksburg, TX 78624-4789
Phone
(314) 604-4618
NPI assigned
Jun 25, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 1, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X W1713 TX Primary
Anesthesiology Physician 207L00000X 04-35744 KS

Addresses

Primary practice location

811 S Milam St
Fredericksburg, TX 78624-4789

Mailing address

PO Box 7909
Longview, TX 75607-7909
Phone (314) 604-4618

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OK
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20260212003722 OK Practitioner - Anesthesiology 8426122946 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology
Education
Other, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Emergenchealth PLLCGroup PAC ID 1355606641, 1,037 clinicians

Practice addresses (Care Compare)

10512 N 110TH E Ave
Bailey Med Ctr
Owasso, OK 74055-6636
Phone (918) 376-8000

1120 S Utica Ave
HC Med Ctr
Tulsa, OK 74104-4012
Phone (918) 579-1000

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
W1713TXMDAnesthesiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Emergenchealth PLLC Anesthesiology CurrentSince Feb 1, 2026 Accepting new patients
Sluh Anesthesia Physicians, L.L.C. Anesthesiology Past Accepting new patients

Locations

10512 N 110th East Ave
Owasso, OK 74055
Phone (918) 272-1172

811 S Milam St
Fredericksburg, TX 78624
Phone (314) 604-4618

Organizations & group practices 2

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": "1182729600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1764547200000",
    "number": "1164628418",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 7909",
            "city": "LONGVIEW",
            "state": "TX",
            "postal_code": "756077909",
            "telephone_number": "314-604-4618"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "811 S MILAM ST",
            "city": "FREDERICKSBURG",
            "state": "TX",
            "postal_code": "786244789",
            "telephone_number": "314-604-4618"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILD",
        "first_name": "DAVID",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-06-25",
        "last_updated": "2025-12-01",
        "certification_date": "2025-12-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "TX",
            "license": "W1713",
            "primary": true
        },
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "KS",
            "license": "04-35744",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fredericksburg, TX

Sources for this page

Verify at the official NPI Registry.