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Contact Information

DAVID L HACKETHORN, MD
1700 UNIVERSITY DR E
COLLEGE STATION, TX77840
 Phone: 979-691-3300
 Fax: 979-691-3527
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Geriatric Medicine

207RG0300X 11 Physician/Internal Medicine
Indicates primary specialty

NPI Profile & details for DAVID L HACKETHORN · (Male)

NPI # 1306806914
Status Active
Credentials MD
Entity Individual
Enumeration date 03/27/2006
Last updated 11/07/2023 - About 3 years ago
Sole proprietor 1 No
Identifiers
  • TX License # E4377
  • TX Other 807442 BLUE SHIELD
Hospital affiliation(s)
  • SCOTT & WHITE HOSPITAL- COLLEGE STATION - (Acute Care)
    700 SCOTT & WHITE DRIVE
    COLLEGE STATION, TX 77845
  • ST JOSEPH REGIONAL HEALTH CENTER - (Acute Care)
    2801 FRANCISCAN DR
    BRYAN, TX 77802
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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