MEDICARE: SCOTT E EWING DO

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	207P00000X	Emergency Medicine Physician	L7372	TX
2	207R00000X	Internal Medicine Physician	L7372	TX
3	207RC0000X	Cardiovascular Disease Physician	L7372	TX
4	207RI0011X	Interventional Cardiology Physician	L7372	TX

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
4	P00660206	OTHER		RAILROAD MEDICARE

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	0057MP	OTHER	TX	BCBS
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1760461800
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SCOTT E EWING DO

Provider Business Mailing Address
First Line	:	200 W MAGNOLIA AVE
Second Line	:
City	:	FORT WORTH
State	:	TX
Zip	:	76104-7644
Country	:	US
Telephone Number	:	817-740-8400
Fax Number	:	817-332-9093

Provider Business Practice Location Address
First Line	:	508 S ADAMS ST STE 100
Second Line	:
City	:	FORT WORTH
State	:	TX
Zip	:	76104-2151
Country	:	US
Telephone Number	:	817-332-5099
Fax Number	:	817-332-9093

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

Provider Enumeration Date	:	01/16/2006
Last Update Date	:	04/28/2025

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Directions to “ SCOTT E EWING DO” Practice Location

Language	Start Address	Practice Location

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