MEDICARE: DR. WILLIAM DAVIDSON OGDEN MD

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	208G00000X	Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician	F4336	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	F4336	OTHER	TX	TX PHYSICIAN PERMIT

General Provider Information

NPI Number	:	1508862525
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. WILLIAM DAVIDSON OGDEN MD

Provider Business Mailing Address
First Line	:	326 PASEO ENCINAL ST
Second Line	:
City	:	SAN ANTONIO
State	:	TX
Zip	:	78212-1708
Country	:	US
Telephone Number	:	210-822-1178
Fax Number	:

Provider Business Practice Location Address
First Line	:	6800 IH10 WEST
Second Line	:	STE 300
City	:	SAN ANTONIO
State	:	TX
Zip	:	78201-2011
Country	:	US
Telephone Number	:	210-616-0008
Fax Number	:	210-616-0231

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

Provider Enumeration Date	:	06/23/2005
Last Update Date	:	07/08/2007

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