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General NPI Number Information
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NPI Number | 1497720817
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Entity Type | Organization
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Legal Business Name | MARK RAY DALTON MD PA
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Dates
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Enumeration Date | 02/20/2006
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Last Update Date | 08/07/2014
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Provider Practice Location Address
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Address Line | 901 W 38TH ST STE 301
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City | AUSTIN
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State | TX
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Zip | 78705-1166
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Country | US
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Telephone | 512-225-6335
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Fax | 512-225-6336
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Provider Business Mailing Address
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Address Line | PO BOX 268969
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City | OKLAHOMA CITY
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State | OK
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Zip | 73126-8969
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Country | US
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Telephone | 512-225-6335
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Fax | 512-225-6336
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Authorized Official
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Title or Position | OWNER/PRESIDENT
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Name | DR. MARK RAY DALTON
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Credential | M.D.
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Telephone | 512-225-6335
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207X00000X
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Taxonomy Name | Orthopaedic Surgery Physician
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License Number |
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 207XX0004X
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Taxonomy Name | Orthopaedic Foot and Ankle Surgery Physician
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License Number |
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License Number State | TX
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