MEDICARE: MR. RONNIE DANIEL VAUGHN BESS, LMTI, LMT

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	174400000X	Specialist	MT025213	TX

General Provider Information

NPI Number	:	1902946866
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. RONNIE DANIEL VAUGHN BESS, LMTI, LMT

Provider Business Mailing Address
First Line	:	903 MESQUITE HOLLOW PL
Second Line	:
City	:	ROUND ROCK
State	:	TX
Zip	:	78664-1200
Country	:	US
Telephone Number	:	512-848-6615
Fax Number	:

Provider Business Practice Location Address
First Line	:	903 MESQUITE HOLLOW PL
Second Line	:
City	:	ROUND ROCK
State	:	TX
Zip	:	78664-1200
Country	:	US
Telephone Number	:	512-848-6615
Fax Number	:

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

Provider Enumeration Date	:	02/07/2007
Last Update Date	:	07/08/2007

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