MEDICARE: DR. SIMON STUDENY 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	207P00000X	Emergency Medicine Physician	N4137	TX
2	207Q00000X	Family Medicine Physician	RL10048	ND

General Provider Information

NPI Number	:	1265657506
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. SIMON STUDENY MD

Provider Business Mailing Address
First Line	:	300 E JOHN CARPENTER FWY
Second Line	:	SUITE 850
City	:	IRVING
State	:	TX
Zip	:	75062-2727
Country	:	US
Telephone Number	:	972-957-3000
Fax Number	:	972-957-3005

Provider Business Practice Location Address
First Line	:	3247 DAWES DR
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75211-5760
Country	:	US
Telephone Number	:	214-330-7767
Fax Number	:	214-330-7780

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

Provider Enumeration Date	:	04/13/2007
Last Update Date	:	01/06/2023

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Directions to “ DR. SIMON STUDENY MD” Practice Location

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