Organization
DAVID S BASTAWROS DPM PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DAVID S. BASTAWROS DPM (PRESIDENT)
(972) 491-3000
Entity
Organization
Contact information
Practice address
4716 ALLIANCE BLVD STE 300, PLANO, TX 75093-5314
(469) 814-3816
(469) 814-3490
Mailing address
PO BOX 261126, PLANO, TX 75026-1126
(972) 491-3000
Taxonomy
Speciality
Code
Description
License number
State
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
1459
TX
261QM1300X
Multi-Specialty Clinic/Center
—
—
261QP1100X
Podiatric Clinic/Center
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
DO2358
MEDICARE RAILROAD
TX
Enumeration date
10/29/2007
Last updated
10/13/2025
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