Provider Demographics
NPI:1154308500
Name:SCOTT, JOHN STUART (DO)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:STUART
Last Name:SCOTT
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 845347
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75284-5347
Mailing Address - Country:US
Mailing Address - Phone:469-291-3369
Mailing Address - Fax:214-645-0078
Practice Address - Street 1:5323 HARRY HINES BLVD
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75390
Practice Address - Country:US
Practice Address - Phone:214-648-6400
Practice Address - Fax:214-648-5461
Is Sole Proprietor?:No
Enumeration Date:2005-12-28
Last Update Date:2019-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXG9889208D00000X, 207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
No208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX135751915Medicaid
TX135751901Medicaid
TX8EH348OtherBCBS
TXP01358434OtherRR
TX135751901Medicaid
TX339227YK6UMedicare PIN
TX89477KMedicare PIN
A67627Medicare UPIN
TX135751908Medicaid
TX135751910Medicaid
TXTXB106600Medicare PIN
TX135751913OtherMEDICAID CSHCN
TX135751901Medicaid
TX135781914OtherMEDICAID CSHCN
TX85094KOtherBCBS
TX135751911Medicaid