Individual provider Active NPI

David Davault

  • Student in an Organized Health Care Education/Training Program
  • Tyler, TX
National Provider Identifier
1497689525
Registry record updated Jun 12, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X
Practice address
17121 Highway 69 S
Tyler, TX 75703-8091
Phone
(903) 316-5711
NPI assigned
Jun 12, 2026
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 12, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X TX Primary

Addresses

Primary practice location

17121 Highway 69 S
Tyler, TX 75703-8091

Mailing address

PO Box 936
Bullard, TX 75757-0936
Phone (903) 316-5711

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)
Not enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Tapestry Counseling of East Texas Past Accepting new patients

Organizations & group practices 1

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": "1781222400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1781222400000",
    "number": "1497689525",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 936",
            "city": "BULLARD",
            "state": "TX",
            "postal_code": "757570936",
            "telephone_number": "903-316-5711"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17121 HIGHWAY 69 S",
            "city": "TYLER",
            "state": "TX",
            "postal_code": "757038091",
            "telephone_number": "903-316-5711"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVAULT",
        "first_name": "DAVID",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2026-06-12",
        "last_updated": "2026-06-12",
        "certification_date": "2026-06-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "TX",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tyler, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 12, 2026; 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.