Provider Demographics
NPI:1902089618
Name:DAVID J. MACDOUGALL, D.O., P.A.
Entity Type:Organization
Organization Name:DAVID J. MACDOUGALL, D.O., P.A.
Other - Org Name:NEUROSURGICAL ASSOCIATES OF HOUSTON
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:JOHN
Authorized Official - Last Name:MACDOUGALL
Authorized Official - Suffix:
Authorized Official - Credentials:DO, PA
Authorized Official - Phone:713-795-5300
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 ROAD
Practice Address - Street 2:SUITE #301
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
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-12-17
Last Update Date:2018-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXG9493207T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207T00000XAllopathic & Osteopathic PhysiciansNeurological SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX148542701Medicaid
TXX53509Medicare UPIN