RUSS TODD NELSON (NPI# 1407841695) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1407841695 |
| Entity Type | Individual |
| Full Name | RUSS TODD NELSON |
| Credential | LPT |
| Practice Address |
4303 Texas Blvd Ste 8 Texarkana TX 75503-3097 |
| Practice Telephone | 9037931797 |
| Practice Fax Number | 9037932105 |
| Mailing Telephone | 9037931797 |
| Mailing Fax Number | 9037932105 |
| Enumeration Date | 2005-09-14 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | X |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 174400000X | Specialist | 1090942 | TX | Other Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| AR | AR BCBS NUMBER | 99451 | 01 |
| TX | TX LICENSE | 1090942 | 01 |
| TX | BCBS ID NUMBER | 86940T | 01 |
| Street Address |
4303 TEXAS BLVD STE 8 |
| City | TEXARKANA |
| State | TX |
| Zip Code | 75503-3097 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174644413 | Janee Marie Atkinson | Dentist | 4303 Texas Blvd, Suite 1, Texarkana, TX 75503 | 2007-04-03 |
| 1275551459 | Connie Gayle Rankin | Occupational Therapist | 4303 Texas Blvd, Suite 8, Texarkana, TX 75503-3097 | 2006-07-17 |
| 1316932502 | David Harmon | Specialist | 4303 Texas Blvd, Ste 8, Texarkana, TX 75503-3097 | 2005-09-14 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1770049397 | Jeffery Nash | Nurse Practitioner | #4 Valley View Circle, Texarkana, TX 75503 | 2019-02-19 |
| 1821583501 | Brandy D Acker | Psychologist | 3615 Richmond Rd, Texarkana, TX 75503 | 2018-06-26 |
| 1366935066 | Samantha Lee Harris | Nurse Practitioner | 4116 Mcknight Rd, Texarkana, TX 75503 | 2018-06-07 |
| 1811416910 | Heather Alison Gerber | Nurse Practitioner | 5903 Brenda Street, Texarkana, TX 75503 | 2017-09-11 |
| 1952838682 | John Kyle Abney | Counselor | 4134 Mcknight Rd, Texarkana, TX 75503 | 2017-05-12 |
| 1699151514 | Piney Woods Er IIi LLC | Clinic/Center | 4102 Gibson Lane, Texarkana, TX 75503 | 2015-08-03 |
| 1609282433 | Colby Rebecca Pair | Physician Assistant | 2604 St. Michael Dr., Suite 310, Texarkana, TX 75503 | 2014-07-01 |
| 1265842496 | Healthcare Express, LLP | Clinic/Center | 3513 Richmond Rd, Texarkana, TX 75503 | 2014-04-28 |
| 1134540628 | Eagle Dental Center of Texarkana Pllc | Dentist | 4009 Moores Ln, Texarkana, TX 75503 | 2013-12-30 |
| 1326481664 | Juancarlo S. Pascual | Family Medicine | 604 St. Michael Dr, Suite 340, Texarkana, TX 75503 | 2013-04-16 |
| Find all providers in zip 75503 | ||||
| Taxonomy Code | 174400000X |
| Grouping | Other Service Providers |
| Classification | Specialist |
| An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |
| Notes: Source: Expanded from Webster’s II New Riverside University Dictionary, Boston: Riverside Publishing Company, 1974. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619142072 | George F. Moricz, M.d., P.a. | Specialist | 1002 Texas Blvd Ste 301, Texarkana, TX 75501-5118 | 2008-04-28 |
| 1154474674 | The Specialists for Women of Texarkana Pllc | Specialist | 1002 Texas Blvd Ste 200, Texarkana, TX 75501-5133 | 2007-01-19 |
| 1568419984 | Texarkana Eye Group Plc | Specialist | 3211 Sugar Hill Rd, Texarkana, AR 71854-9219 | 2006-05-30 |
| 1871546051 | Roger Dale House | Specialist | 2401 Summerhill Rd, Suite A, Texarkana, TX 75501-3570 | 2006-05-18 |
| 1104884386 | Mark A Wren | Specialist | 4613 Parkway Dr Ste 1, Texarkana, AR 71854-1142 | 2006-05-03 |
| 1962490458 | Charles Edward Hollingsworth II | Specialist | 5420 Medical Parkway Dr, Texarkana, TX 75503-4622 | 2005-10-10 |
| 1063419307 | Hayden H Franks | Specialist | 2011 Moores Ln, Texarkana, TX 75503-1841 | 2005-07-01 |
| 1063419646 | Stanley Cleveland Knowles | Specialist | 1920 Moores Ln, Suite A, Texarkana, TX 75503-4664 | 2005-06-28 |
| 1649275496 | David Lee Carlisle | Specialist | 1000 Pine St, Texarkana, TX 75501-5100 | 2005-06-17 |
| 1245235092 | Richard Jackson Payne | Specialist | 2602 Saint Michael Dr, Suite 301, Texarkana, TX 75503-2387 | 2005-06-17 |
| Find all providers in TEXARKANA | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.