MEDICARE: DAVID W BOONE 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	207X00000X	Orthopaedic Surgery Physician	G7168	TX
2	207XS0114X	Adult Reconstructive Orthopaedic Surgery Physician	G7168	TX

General Provider Information

NPI Number	:	1871516070
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DAVID W BOONE MD

Provider Business Mailing Address
First Line	:	3503 W WHEATLAND RD
Second Line	:	STE 100
City	:	DALLAS
State	:	TX
Zip	:	75237-3461
Country	:	US
Telephone Number	:	972-298-3337
Fax Number	:	972-298-4516

Provider Business Practice Location Address
First Line	:	3503 W WHEATLAND RD
Second Line	:	STE 100
City	:	DALLAS
State	:	TX
Zip	:	75237-3461
Country	:	US
Telephone Number	:	972-298-3337
Fax Number	:	972-298-4516

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

Provider Enumeration Date	:	07/26/2006
Last Update Date	:	03/27/2008

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Directions to “ DAVID W BOONE MD” Practice Location

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