MEDICARE: DR. DAUN JOHNSON LAI 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	207L00000X	Anesthesiology Physician	Q3222	TX

General Provider Information

NPI Number	:	1346454675
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DAUN JOHNSON LAI MD

Provider Business Mailing Address
First Line	:	19179 BLANCO RD
Second Line	:	STE 105-171
City	:	SAN ANTONIO
State	:	TX
Zip	:	78258-4042
Country	:	US
Telephone Number	:	210-614-0180
Fax Number	:

Provider Business Practice Location Address
First Line	:	3698 CHAMBERS PASS
Second Line	:
City	:	FORT SAM HOUSTON
State	:	TX
Zip	:	78234
Country	:	US
Telephone Number	:	210-916-3333
Fax Number	:

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

Provider Enumeration Date	:	05/09/2007
Last Update Date	:	06/30/2016

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