Healthcare Provider Details

I. General information

NPI: 1033196050
Provider Name (Legal Business Name): OSCAR DAVID TAUNTON JR. MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/30/2005
Last Update Date: 07/16/2024
Certification Date: 07/16/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2425 HIGHWAY 121
BEDFORD TX
76021-5013
US

IV. Provider business mailing address

2425 HIGHWAY 121
BEDFORD TX
76021-5013
US

V. Phone/Fax

Practice location:
  • Phone: 817-540-4477
  • Fax: 817-510-0185
Mailing address:
  • Phone: 817-540-4477
  • Fax: 817-540-5633

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License NumberK8847
License Number StateTX
# 2
Primary TaxonomyN
Taxonomy Code207XS0114X
TaxonomyAdult Reconstructive Orthopaedic Surgery Physician
License NumberK8847
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: