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General NPI Number Information
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NPI Number | 1356313274
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Entity Type | Individual
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Provider Name | WARREN R DALTON MD
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Gender | Male
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Dates
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Enumeration Date | 02/03/2006
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Last Update Date | 06/27/2012
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Provider Practice Location Address
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Address Line | 2484 STANLEY ROAD, SUITE 91, BLDG 2236 DEFENSE MEDICAL READINESS TRAINING INSTITUTE
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City | FORT SAM HOUSTON
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State | TX
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Zip | 78234
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Country | US
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Telephone | 210-221-2108
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Fax |
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Provider Business Mailing Address
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Address Line | 1618 POETS CORNER ST
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City | SAN ANTONIO
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State | TX
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Zip | 78232-4839
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Country | US
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Telephone | 210-392-8725
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number | ME92139
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number | A44721
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License Number State | CA
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