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General NPI Number Information
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NPI Number | 1780134122
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Entity Type | Organization
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Legal Business Name | TEAXAS MEDICAL RESULTS, LLC
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Dates
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Enumeration Date | 10/10/2016
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Last Update Date | 10/10/2016
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Provider Practice Location Address
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Address Line | 1708 COIT RD STE 150
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City | PLANO
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State | TX
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Zip | 75075-6198
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Country | US
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Telephone | 214-440-3007
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Fax | 972-608-0005
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Provider Business Mailing Address
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Address Line | 5500 DEMOCRACY DR STE 150
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City | PLANO
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State | TX
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Zip | 75024-4202
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Country | US
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Telephone | 214-440-3007
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Fax | 972-608-0005
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Authorized Official
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Title or Position | SOLE MEMBER
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Name | DR. WILLIAM DANIEL NICHOLSON IV
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Credential | MD
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Telephone | 972-494-3100
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number | L1953
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License Number State | TX
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