MEDICARE: DAVID K LIVINGSTONE 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	207Q00000X	Family Medicine Physician	D9549	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

General Provider Information

NPI Number	:	1588654511
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DAVID K LIVINGSTONE MD

Provider Business Mailing Address
First Line	:	PO BOX 210907
Second Line	:	KANER MEDICAL GROUP
City	:	BEDFORD
State	:	TX
Zip	:	76095-7907
Country	:	US
Telephone Number	:	817-358-5800
Fax Number	:	817-283-7686

Provider Business Practice Location Address
First Line	:	412 N MAIN ST
Second Line	:	SUITE 100
City	:	EULESS
State	:	TX
Zip	:	76039-3652
Country	:	US
Telephone Number	:	817-358-5800
Fax Number	:	817-546-8672

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

Provider Enumeration Date	:	10/21/2005
Last Update Date	:	02/09/2012

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Directions to “ DAVID K LIVINGSTONE MD” Practice Location

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