MEDICARE: DR. DAVID K SCALES M.D.

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	207W00000X	Ophthalmology Physician	K4232	TX
2	207WX0107X	Retina Specialist (Ophthalmology) Physician	K4232	TX
3	207WX0108X	Uveitis and Ocular Inflammatory Disease (Ophthalmology) Physician	K4232	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1164412029
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DAVID K SCALES M.D.

Provider Business Mailing Address
First Line	:	9623 HUEBNER RD
Second Line	:	SUITE 100
City	:	SAN ANTONIO
State	:	TX
Zip	:	78240-1664
Country	:	US
Telephone Number	:	210-615-6565
Fax Number	:	210-615-6568

Provider Business Practice Location Address
First Line	:	9623 HUEBNER RD
Second Line	:	SUITE 100
City	:	SAN ANTONIO
State	:	TX
Zip	:	78240-1664
Country	:	US
Telephone Number	:	210-615-6565
Fax Number	:	210-615-6568

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

Provider Enumeration Date	:	10/24/2005
Last Update Date	:	04/06/2017

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Directions to “ DR. DAVID K SCALES M.D.” Practice Location

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