| Doctor Name: | DAVID LARRES |
| NPI Number: | 1609951250 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | |
| License Number: | 31001991A |
| Business Practice Address: | Reynolds Army Community Hospital 4301 Mow-away Rd Fort Sill, OK - 73503 |
| Business Phone Number: | 5804583461 |
| Business Fax Number: | |
| Mailing Address: | 11194 N.e. Meers-porter Hill Rd, ELGIN |
| State: | OK |
| Postal Code: | 73538 |
| Phone Number: | 5804924438 |
| Fax Number: | |
| NPI Enumeration Date: | 10/25/2006 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 171000000X |
| License Number: | 31001991A |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | IN |
| Taxonomy Type: | Other Service Providers |
| Taxonomy Classification: | Military Health Care Provider |
| Taxonomy Specialization: | |
| Taxonomy Definition: | Active duty military health care providers not otherwise classified who need to be separately identified for operational, clinical, or administrative processes. |