MEDICARE: DON BUFORD JR MD PA

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	207XX0005X	Sports Medicine (Orthopaedic Surgery) Physician	J7439	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	0065GM	OTHER	TX	BCBS GROUP NUMBER

General Provider Information

NPI Number	:	1417176728
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DON BUFORD JR MD PA

Provider Business Mailing Address
First Line	:	3310 LIVE OAK ST STE 202
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75204-8724
Country	:	US
Telephone Number	:	877-777-8883
Fax Number	:	888-818-0383

Provider Business Practice Location Address
First Line	:	3310 LIVE OAK ST STE 202
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75204-8724
Country	:	US
Telephone Number	:	877-777-8883
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	DR. DON ALEX BUFORD
Credential	:	MD
Telephone Number	:	469-674-5074

Provider Enumeration Date	:	04/25/2007
Last Update Date	:	03/24/2026

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