Provider Demographics
NPI:1023083482
Name:WITHEILER, DANIEL D (MD)
Entity type:Individual
Prefix:DR
First Name:DANIEL
Middle Name:D
Last Name:WITHEILER
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Gender:M
Credentials:MD
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Mailing Address - Street 1:1411 N BECKLEY AVE
Mailing Address - Street 2:PAVILION III, SUITE 470
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75203-1264
Mailing Address - Country:US
Mailing Address - Phone:214-941-7546
Mailing Address - Fax:214-941-2442
Practice Address - Street 1:1411 N BECKLEY AVE
Practice Address - Street 2:PAVILION III, SUITE 470
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75203-1264
Practice Address - Country:US
Practice Address - Phone:214-941-7546
Practice Address - Fax:214-941-2442
Is Sole Proprietor?:No
Enumeration Date:2006-02-21
Last Update Date:2023-08-01
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Provider Licenses
StateLicense IDTaxonomies
TXJ2420207ND0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ND0101XAllopathic & Osteopathic PhysiciansDermatologyMOHS-Micrographic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXG35272Medicare UPIN
TX0040ASMedicare PIN