Birdwell, Russ Deacon

Birdwell, Russ Deacon is an individual health care provider with primary practice located at 3600 Shire Blvd Suite 104, Richardson TX 75082-2240. He recently has only one registered license in Allopathic & Osteopathic Physicians / Surgery, which is considered as his primary health care specialty. Birdwell, Russ Deacon can be contacted via phone (972) 487-6400.

Contact Information

Primary practice address
3600 Shire Blvd Suite 104 Richardson TX 75082-2240
Phone: (972) 487-6400
Fax: (972) 487-1686
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Surgery 208600000X G71405 Texas

Profile Details

NPI number 1376595991
LBN Legal business name Birdwell, Russ Deacon
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date May 16th, 2006
Last updated Mar 7th, 2022 - about 4 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1376595991 NPPES
Texas MEDICAID 105418103

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