MEDICARE: HENRY HUNTINGTON BATJER III 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	207T00000X	Neurological Surgery Physician	036091382	IL

General Provider Information

NPI Number	:	1518931104
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	HENRY HUNTINGTON BATJER III MD

Provider Business Mailing Address
First Line	:	PO BOX 845347
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75284-5347
Country	:	US
Telephone Number	:	214-645-2300
Fax Number	:	214-645-2301

Provider Business Practice Location Address
First Line	:	5303 HARRY HINES BLVD
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75390-9167
Country	:	US
Telephone Number	:	214-645-2300
Fax Number	:	214-645-2301

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

Provider Enumeration Date	:	02/13/2006
Last Update Date	:	09/04/2012

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