Nystrom, Gerald

Nystrom, Gerald is an individual health care provider with primary practice located at 7777 Forest Ln , Dallas TX 75230-2571. He recently has only one registered license in Allopathic & Osteopathic Physicians / Neonatal-Perinatal Medicine, which is considered as his primary health care specialty. Nystrom, Gerald can be contacted via phone (214) 343-6663.

Contact Information

Primary practice address
7777 Forest Ln Dallas TX 75230-2571
Phone: (214) 343-6663
Fax: (214) 343-2814
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Neonatal-Perinatal Medicine 2080N0001X K6194 Texas

Profile Details

NPI number 1437111614
LBN Legal business name Nystrom, Gerald
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Apr 4th, 2006
Last updated Jan 3rd, 2022 - about 2 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 1437111614 NPPES
Texas Other K6194 LICENSE
Texas MEDICAID 040275201 LICENSE

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