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General NPI Number Information
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NPI Number | 1306846084
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Entity Type | Individual
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Provider Name | NOLAN DANIEL SHIPMAN M.D.
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Gender | Male
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Dates
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Enumeration Date | 07/26/2005
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Last Update Date | 03/29/2012
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Provider Practice Location Address
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Address Line | 3201 UNIVERSITY DR E SUITE 375
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City | BRYAN
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State | TX
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Zip | 77802-3485
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Country | US
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Telephone | 979-731-8284
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Fax | 979-774-0875
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Provider Business Mailing Address
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Address Line | 3201 UNIVERSITY DR E SUITE 375
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City | BRYAN
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State | TX
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Zip | 77802-3485
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Country | US
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Telephone | 979-731-8284
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Fax | 979-774-0875
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Y00000X
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Taxonomy Name | Otolaryngology Physician
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License Number | E3115
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License Number State | TX
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