| Doctor Name: | DR. RUSSELL SCOTT WARREN |
| NPI Number: | 1386822237 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | DDS, M.D. |
| License Number: | M9730 |
| Business Practice Address: | 103 Burnett Ct Woodway, TX - 767123100 |
| Business Phone Number: | 2543999925 |
| Business Fax Number: | 2543999930 |
| Mailing Address: | 103 Burnett Ct, WOODWAY |
| State: | TX |
| Postal Code: | 767123100 |
| Phone Number: | 2543999925 |
| Fax Number: | 2543999930 |
| NPI Enumeration Date: | 02/02/2008 |
| NPI Last Update Date: | 09/30/2008 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 204E00000X |
| License Number: | M9730 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | TX |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | Oral & Maxillofacial Surgery |
| Taxonomy Specialization: | |
| Taxonomy Definition: | |