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TELLER, DAVID CROCKETT       
This verification service provides current data extracted by the Oklahoma State Board of Medical Licensure and Supervision (OSBMLS) from its own database. The data enclosed in the green box below is provided by and controlled entirely by the OSBMLS and therefore constitutes a primary source verification of licensure status as authentic as a direct inquiry to the OSBMLS. NPI# and hospital privileges (if any) are provided by the licensee and not verified.
Practice Address: 1014 MEMORIAL DR #308
DENISON TX 75020
Phone #:
Fax #:
County: NOT OKLAHOMA
License: 20178
Dated: 7/1/1997
Expires: 7/1/2000
License Type: Medical Doctor
Specialty: Otolaryngology
Facial Plastic Surgery
Status: Inactive
Status Class: Expired License
Restricted to:
Registered to Dispense: NO
Medical School: Univ Of Tx Med Branch Galveston, Galveston Tx 77550
Graduated: 5 / 1986
CME Year: 2000
Pending and/or Past Disciplinary Actions: No Disciplinary Action Taken.
All information below is entered by the licensee but not verified by the Oklahoma Medical Board.
Certifications: AMERICAN BOARD OF OTOLARYNGOLOGY
New Patients: Contact licensee
Medicaid: Contact licensee
Medicare: Contact licensee
   
HMO/PPO: None listed
Hospital Privileges: None listed
Locations: Hours: Languages:
1014 MEMORIAL DR #308
DENISON TX 75020

Phone #:
Fax #:

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