Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207XS0117X | Orthopaedic Spine Surgeon | L9018 | TX |
NPI | 1194765552 |
---|---|
Provider Name | Douglas S Won |
First Address | Dallas, TX 75320-2737 |
Second Address | Irving, TX 75038-6497 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 07/06/2006 |
Last Update Date | 02/02/2010 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0047LY | BLUE CROSS (01) | TX |
171385101 | (05) | TX |
I10492 | (02) | TX |
P00218970 | RAILROAD MEDICARE (01) | TX |