MEDICARE: DR. DANIELLE R FORD 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	207R00000X	Internal Medicine Physician	ME100879	FL
2	207R00000X	Internal Medicine Physician	N3645	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	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1568601516
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DANIELLE R FORD MD

Provider Business Mailing Address
First Line	:	3824 CEDAR SPRINGS RD # 238
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75219-4136
Country	:	US
Telephone Number	:	214-810-8808
Fax Number	:

Provider Business Practice Location Address
First Line	:	2400 N INTERSTATE HIGHWAY 35 E
Second Line	:
City	:	WAXAHACHIE
State	:	TX
Zip	:	75165-5240
Country	:	US
Telephone Number	:	469-843-4000
Fax Number	:

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

Provider Enumeration Date	:	02/16/2009
Last Update Date	:	03/31/2022

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