Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208200000X | Surgeon | BP10050873 | TX |
N | 208600000X | Surgeon | BP10050873 | TX |
Y | 2086S0122X | Plastic and Reconstructive Surgery | S7578 | TX |
NPI | 1326468521 |
---|---|
Provider Name | Nicholas David Webster |
First Address | Dallas, TX 75284-4658 |
Second Address | Temple, TX 76508-0001 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 26/04/2014 |
Last Update Date | 23/09/2021 |