Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RN0300X | Nephrologist | D9660 | TX |
NPI | 1063483865 |
---|---|
Provider Name | Russell Silverstein |
First Address | Dallas, TX 75235-2208 |
Second Address | Dallas, TX 75240-5773 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 30/01/2006 |
Last Update Date | 22/01/2008 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
C21817 | (02) | TX |