Provider Demographics
NPI:1376662726
Name:MACDOUGALL, DAVID JOHN (DO, FACOS, PA)
Entity Type:Individual
Prefix:MR
First Name:DAVID
Middle Name:JOHN
Last Name:MACDOUGALL
Suffix:
Gender:M
Credentials:DO, FACOS, PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3211 SAVELL DR
Mailing Address - Street 2:
Mailing Address - City:BAYTOWN
Mailing Address - State:TX
Mailing Address - Zip Code:77521-2700
Mailing Address - Country:US
Mailing Address - Phone:713-795-5300
Mailing Address - Fax:713-795-5720
Practice Address - Street 1:4201 GARTH RD STE 205
Practice Address - Street 2:
Practice Address - City:BAYTOWN
Practice Address - State:TX
Practice Address - Zip Code:77521
Practice Address - Country:US
Practice Address - Phone:713-795-5300
Practice Address - Fax:713-795-5720
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-28
Last Update Date:2018-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXG9493207T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207T00000XAllopathic & Osteopathic PhysiciansNeurological Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX8109M0Medicare ID - Type UnspecifiedMEDICARE PROVIDER #
TXE60678Medicare UPIN