Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223X0400X | Orthodontists | 21599 | TX |
NPI | 1023120300 |
---|---|
Provider Name | Dr. Carlos Nurko |
First Address | Plano, TX 75093-3860 |
Second Address | Frisco, TX 75034-5823 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 31/08/2006 |
Last Update Date | 08/07/2007 |