Healthcare Provider Details

I. General information

NPI: 1154948198
Provider Name (Legal Business Name): WALKER PLASTIC SURGERY PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/25/2020
Last Update Date: 06/25/2020
Certification Date: 06/25/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12590 DALLAS PKWY STE 200
FRISCO TX
75034
US

IV. Provider business mailing address

12590 DALLAS PKWY STE 200
FRISCO TX
75034
US

V. Phone/Fax

Practice location:
  • Phone: 469-850-3253
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2086S0122X
TaxonomyPlastic and Reconstructive Surgery Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. NICHOLAS WALKER
Title or Position: OWNER
Credential: MD
Phone: 469-850-3253