Provider Demographics
NPI:1871516070
Name:BOONE, DAVID W (MD)
Entity type:Individual
Prefix:
First Name:DAVID
Middle Name:W
Last Name:BOONE
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:3503 W WHEATLAND RD
Mailing Address - Street 2:STE 100
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75237-3461
Mailing Address - Country:US
Mailing Address - Phone:972-298-3337
Mailing Address - Fax:972-298-4516
Practice Address - Street 1:3503 W WHEATLAND RD
Practice Address - Street 2:STE 100
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75237-3461
Practice Address - Country:US
Practice Address - Phone:972-298-3337
Practice Address - Fax:972-298-4516
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-26
Last Update Date:2008-03-27
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Provider Licenses
StateLicense IDTaxonomies
TXG7168207X00000X, 207XS0114X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
No207XS0114XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryAdult Reconstructive Orthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
00QV32Medicare ID - Type Unspecified
B21381Medicare UPIN