Provider Demographics
NPI:1790131886
Name:BOONE, DAVID LYNN JR (MD)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:LYNN
Last Name:BOONE
Suffix:JR
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:6400 FANNIN ST STE 2550
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77030-1538
Mailing Address - Country:US
Mailing Address - Phone:713-500-6500
Mailing Address - Fax:713-500-6497
Practice Address - Street 1:6400 FANNIN ST STE 2550
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77030-1538
Practice Address - Country:US
Practice Address - Phone:713-500-6500
Practice Address - Fax:713-500-6497
Is Sole Proprietor?:No
Enumeration Date:2016-05-09
Last Update Date:2023-05-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXR1492207R00000X
390200000X
TXR4192207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program