Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080A0000X | Adolescent Medicine | F1844 | TX |
NPI | 1225128028 |
---|---|
Provider Name | Daniel D. Nale |
First Address | Dallas, TX 75251-2100 |
Second Address | Dallas, TX 75251-2100 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 13/10/2006 |
Last Update Date | 06/07/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
752627927 | CORP TAX ID (01) |