MEDICARE: DR. DENTON WATUMULL MD

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	2086S0105X	Surgery of the Hand (Surgery) Physician	G6096	TX
2	2086S0122X	Plastic and Reconstructive Surgery Physician	G6096	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	:	1225073216
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DENTON WATUMULL MD

Provider Business Mailing Address
First Line	:	3201 GEORGE BUSH HWY
Second Line	:	#101
City	:	RICHARDSON
State	:	TX
Zip	:	75082-3566
Country	:	US
Telephone Number	:	972-470-5000
Fax Number	:	972-470-5002

Provider Business Practice Location Address
First Line	:	3201 GEORGE BUSH HWY
Second Line	:	#101
City	:	RICHARDSON
State	:	TX
Zip	:	75082-3566
Country	:	US
Telephone Number	:	972-470-5000
Fax Number	:	972-470-5002

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

Provider Enumeration Date	:	06/17/2006
Last Update Date	:	02/11/2008

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Directions to “ DR. DENTON WATUMULL MD” Practice Location

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