Individual provider Active NPI

David Lynn Liland, M.D.

  • Plastic Surgery Physician
  • Dallas, TX
National Provider Identifier
1790830974
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Plastic Surgery PhysicianTaxonomy code 208200000X
License
G5300 Issued in TX
Practice address
4509 Lemmon Ave.
Dallas, TX 75219-2145
Phone
(214) 692-6500
Fax
(214) 265-1570
NPI assigned
Jan 25, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Plastic Surgery Physician 208200000X G5300 TX Primary

Addresses

Primary practice location

4509 Lemmon Ave.
Dallas, TX 75219-2145

Mailing address

4509 Lemmon Ave.
Dallas, TX 75219-2145
Phone (214) 692-6500

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20140807002193 TX Order and Referring Only - Plastic and Reconstructive SurgeryPractitioner - Plastic and Reconstructive Surgery 6305063785

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
G5300TXMDPlastic Surgery Physician

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1169683200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1790830974",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4509 LEMMON AVE.",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752192145",
            "telephone_number": "214-692-6500",
            "fax_number": "214-265-1570"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4509 LEMMON AVE.",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752192145",
            "telephone_number": "214-692-6500",
            "fax_number": "214-265-1570"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LILAND",
        "first_name": "DAVID",
        "middle_name": "LYNN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-01-25",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208200000X",
            "taxonomy_group": "",
            "desc": "Plastic Surgery",
            "state": "TX",
            "license": "G5300",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dallas, TX

Sources for this page

Verify at the official NPI Registry.