MEDICARE: DR. DANIEL LAIDLEY M.D.

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	J1712	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	8BW922	OTHER	TX	BCBC
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4	8EH521	OTHER	TX	BCBS TX
5	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
6	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1548262595
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DANIEL LAIDLEY M.D.

Provider Business Mailing Address
First Line	:	PO BOX 650865
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75265-0865
Country	:	US
Telephone Number	:	972-715-5000
Fax Number	:

Provider Business Practice Location Address
First Line	:	6606 LBJ FWY STE 200
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75240-6524
Country	:	US
Telephone Number	:	972-715-5000
Fax Number	:

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

Provider Enumeration Date	:	06/02/2005
Last Update Date	:	10/29/2015

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Directions to “ DR. DANIEL LAIDLEY M.D.” Practice Location

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