Nelson, Russ Todd

Nelson, Russ Todd is an individual health care provider with primary practice located at 4303 Texas Blvd Ste 8, Texarkana TX 75503-3097. He recently has only one registered license in Other Service Providers / Specialist, which is considered as his primary health care specialty. Nelson, Russ Todd can be contacted via phone (903) 793-1797.

Contact Information

Primary practice address
4303 Texas Blvd Ste 8 Texarkana TX 75503-3097
Phone: (903) 793-1797
Fax: (903) 793-2105
Website:
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Health care specialties

SpecialtyCodeLicense #State
Other Service Providers / Specialist 174400000X 1090942 Texas

Profile Details

NPI number 1407841695
LBN Legal business name Nelson, Russ Todd
Credentials LPT
Entity Individual
Sole proprietor 1 No
Enumeration date Sep 14th, 2005
Last updated Jul 8th, 2007 - about 17 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 1407841695 NPPES
Texas Other 1090942 TX LICENSE
Texas Other 99451 TX LICENSE
Texas Other 86940T TX LICENSE

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