MEDICARE: DOUGLAS S WON 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	207XS0117X	Orthopaedic Surgery of the Spine Physician	L9018	TX

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	P00218970	OTHER	TX	RAILROAD MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	0047LY	OTHER	TX	BLUE CROSS
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1194765552
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DOUGLAS S WON M.D.

Provider Business Mailing Address
First Line	:	PO BOX 202737
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75320-2737
Country	:	US
Telephone Number	:	972-255-5588
Fax Number	:	972-255-6688

Provider Business Practice Location Address
First Line	:	4301 N MACARTHUR BLVD
Second Line	:	SUITE 101
City	:	IRVING
State	:	TX
Zip	:	75038-6497
Country	:	US
Telephone Number	:	972-255-5588
Fax Number	:	972-255-6688

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

Provider Enumeration Date	:	06/07/2006
Last Update Date	:	02/02/2010

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Directions to “ DOUGLAS S WON M.D.” Practice Location

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