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General NPI Number Information
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NPI Number | 1942210398
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Entity Type | Individual
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Provider Name | NIKKI ANDERSON WALDEN M.D.
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Gender | Female
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Dates
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Enumeration Date | 08/08/2006
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Last Update Date | 05/12/2008
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Provider Practice Location Address
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Address Line | 4325 N JOSEY LN SUITE 300
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City | CARROLLTON
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State | TX
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Zip | 75010-4635
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Country | US
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Telephone | 972-820-9333
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Fax | 972-492-8600
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Provider Business Mailing Address
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Address Line | PO BOX 118383
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City | CARROLLTON
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State | TX
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Zip | 75011-8383
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Country | US
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Telephone | 972-820-9333
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Fax | 972-492-8600
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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 | 174400000X
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Taxonomy Name | Specialist
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License Number | L8999
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number | L8999
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License Number State | TX
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