MEDICARE: DOUGLAS S. WON, 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	207XS0117X	Orthopaedic Surgery of the Spine Physician	L9018	TX

General Provider Information

NPI Number	:	1437376555
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DOUGLAS S. WON, MD, PA

Provider Business Mailing Address
First Line	:	P. O. BOX 202737
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75320-2737
Country	:	US
Telephone Number	:	972-701-8826
Fax Number	:	972-503-1051

Provider Business Practice Location Address
First Line	:	4301 N MACARTHUR BLVD STE 101
Second Line	:
City	:	IRVING
State	:	TX
Zip	:	75038-6497
Country	:	US
Telephone Number	:	972-255-5588
Fax Number	:	972-255-6688

Authorized Official
Title or Position	:	PHYSICIAN
Name	:	DOUGLAS S WON
Credential	:	MD
Telephone Number	:	972-255-5588

Provider Enumeration Date	:	04/19/2007
Last Update Date	:	09/11/2010

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