MEDICARE: DR. JAMES DOUGLAS BATES D.D.S., 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	1223S0112X	Oral and Maxillofacial Surgery (Dentist)	12096	TX
2	204E00000X	Oral & Maxillofacial Surgery (D.M.D.)	H0164	TX

General Provider Information

NPI Number	:	1730172347
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JAMES DOUGLAS BATES D.D.S., M.D.

Provider Business Mailing Address
First Line	:	3001 KNOX ST STE 301
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75205-5593
Country	:	US
Telephone Number	:	214-824-8960
Fax Number	:	214-824-8984

Provider Business Practice Location Address
First Line	:	3001 KNOX ST
Second Line	:	SUITE 301
City	:	DALLAS
State	:	TX
Zip	:	75205-5584
Country	:	US
Telephone Number	:	214-824-8960
Fax Number	:	214-824-8984

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

Provider Enumeration Date	:	08/30/2005
Last Update Date	:	03/19/2026

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