MEDICARE: MR. SCOTT MCEWAN

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	343900000X	Non-emergency Medical Transport (VAN)	CSR1661	TX

General Provider Information

NPI Number	:	1588040208
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. SCOTT MCEWAN

Provider Business Mailing Address
First Line	:	6041 VILLAGE BEND DR
Second Line	:	1105
City	:	DALLAS
State	:	TX
Zip	:	75206-3600
Country	:	US
Telephone Number	:	214-288-2810
Fax Number	:	469-283-0603

Provider Business Practice Location Address
First Line	:	6041 VILLAGE BEND DR
Second Line	:	1105
City	:	DALLAS
State	:	TX
Zip	:	75206-3600
Country	:	US
Telephone Number	:	214-288-2810
Fax Number	:	469-283-0603

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

Provider Enumeration Date	:	08/04/2015
Last Update Date	:	08/04/2015

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Directions to “ MR. SCOTT MCEWAN ” Practice Location

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