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NPI Code Detail

MEDICARE: JOHN NUSS PA-C

MEDICARE: JOHN NUSS PA-C
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
1363A00000XPhysician Assistant

General Provider Information

NPI Number : 1770963571
Entity Type Code : Individual
Provider Name (Legal Business Name) : JOHN NUSS PA-C
Provider Business Mailing Address
First Line : 663 FLETCHER DR
Second Line :
City : FATE
State : TX
Zip : 75087-0510
Country : US
Telephone Number : 214-789-9158
Fax Number :
Provider Business Practice Location Address
First Line : 4835 LYNDON B JOHNSON FWY STE 900
Second Line :
City : DALLAS
State : TX
Zip : 75244-6001
Country : US
Telephone Number : 844-539-6332
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/05/2015
Last Update Date : 07/09/2024

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