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General NPI Number Information
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NPI Number | 1619235744
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Entity Type | Individual
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Provider Name | DANIEL MARK KOEHLER M.D.
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Gender | Male
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Dates
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Enumeration Date | 04/26/2012
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Last Update Date | 12/03/2019
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Provider Practice Location Address
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Address Line | 1801 INWOOD ROAD
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City | DALLAS
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State | TX
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Zip | 75390-8882
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Country | US
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Telephone | 214-645-0480
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Fax |
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Provider Business Mailing Address
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Address Line | 660 SOUTH EUCLID AVENUE CAMPUS BOX 8233
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City | SAINT LOUIS
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State | MO
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Zip | 63110
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Country | US
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Telephone |
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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 | 207XS0106X
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Taxonomy Name | Orthopaedic Hand Surgery Physician
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License Number | 2017004303
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License Number State | MO
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Taxonomy #2
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Taxonomy Code | 207XS0106X
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Taxonomy Name | Orthopaedic Hand Surgery Physician
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License Number | R6218
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License Number State | TX
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Taxonomy #3
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Taxonomy Code | 207X00000X
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Taxonomy Name | Orthopaedic Surgery Physician
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License Number | R-9390
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License Number State | IA
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