MEDICARE: WALTER STATON M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207P00000X	Emergency Medicine Physician	G0161	TX

General Provider Information

NPI Number	:	1104016112
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	WALTER STATON M.D.

Provider Business Mailing Address
First Line	:	8500 N STEMMONS FWY
Second Line	:	SUITE 6077
City	:	DALLAS
State	:	TX
Zip	:	75247-3832
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	8500 N STEMMONS FWY
Second Line	:	SUITE 6077
City	:	DALLAS
State	:	TX
Zip	:	75247-3832
Country	:	US
Telephone Number	:	214-678-0500
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/26/2007
Last Update Date	:	07/26/2007

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