Healthcare Provider Details

I. General information

NPI: 1285991851
Provider Name (Legal Business Name): JONATHAN SCOTT NELSON M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/19/2012
Last Update Date: 08/26/2026
Certification Date: 08/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3537 S INTERSTATE 35 E STE 315
DENTON TX
76210-6870
US

IV. Provider business mailing address

3537 S INTERSTATE 35 E STE 315
DENTON TX
76210-6870
US

V. Phone/Fax

Practice location:
  • Phone: 940-536-0706
  • Fax: 940-536-0710
Mailing address:
  • Phone: 940-536-0706
  • Fax: 940-536-0710

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208800000X
TaxonomyUrology Physician
License NumberR2185
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: