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General NPI Number Information
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NPI Number | 1548530843
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Entity Type | Organization
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Legal Business Name | NIRMAL S JAYASEELAN M D P A
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Dates
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Enumeration Date | 01/04/2012
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Last Update Date | 01/04/2012
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Provider Practice Location Address
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Address Line | 11970 N CENTRAL EXPY SUITE 670
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City | DALLAS
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State | TX
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Zip | 75243-3768
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Country | US
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Telephone | 972-331-1111
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Fax |
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Provider Business Mailing Address
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Address Line | 9221 SUNNYBROOK LN
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City | DALLAS
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State | TX
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Zip | 75220-3949
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Country | US
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Telephone | 214-361-2052
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Fax |
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Authorized Official
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Title or Position | SURGEON
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Name | DR. NIRMAL SAMUEL JAYASEELAN
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Credential | M.D.
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Telephone | 972-331-1111
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QA1903X
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Taxonomy Name | Ambulatory Surgical Clinic/Center
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License Number | K8233
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License Number State | TX
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