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General NPI Number Information
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NPI Number | 1447517594
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Entity Type | Individual
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Provider Name | JESSICA MARIE NELSON M.D.
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Gender | Female
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Dates
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Enumeration Date | 04/13/2012
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Last Update Date | 04/09/2021
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Provider Practice Location Address
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Address Line | 3160 JUSTIN RD
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City | HIGHLAND VILLAGE
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State | TX
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Zip | 75077-7049
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Country | US
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Telephone | 214-247-7728
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Fax | 469-863-8956
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Provider Business Mailing Address
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Address Line | 2427 SOUTHWOOD DR
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City | DALLAS
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State | TX
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Zip | 75233-2837
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Country | US
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Telephone | 214-693-4372
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Fax |
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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 | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number | P8957
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License Number State | TX
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