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NPI Code Detail

MEDICARE: DR. NATHAN SCOTT WALTERS M.D.

MEDICARE: DR. NATHAN SCOTT WALTERS M.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
12081P2900XPain Medicine (Physical Medicine & Rehabilitation) PhysicianL7595TX
2208100000XPhysical Medicine & Rehabilitation PhysicianL7595TX

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1L7595OTHERTXTMB

General Provider Information

NPI Number : 1639259294
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. NATHAN SCOTT WALTERS M.D.
Provider Business Mailing Address
First Line : 7115 GREENVILLE AVE STE 230
Second Line :
City : DALLAS
State : TX
Zip : 75231-5104
Country : US
Telephone Number : 214-888-3888
Fax Number : 214-888-3889
Provider Business Practice Location Address
First Line : 4849 GREENVILLE AVE STE 1180
Second Line :
City : DALLAS
State : TX
Zip : 75206-4130
Country : US
Telephone Number : 214-888-3888
Fax Number : 214-888-3889
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/17/2006
Last Update Date : 10/20/2024

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