Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111N00000X | Chiropractor | 2844 | TX |
NPI | 1003086687 |
---|---|
Provider Name | Dr. Roland Daniel Nadeau |
First Address | Dallas, TX 75209-4330 |
Second Address | Dallas, TX 75209-4330 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 10/03/2008 |
Last Update Date | 10/03/2008 |