| Dan A. Waddell, D.o., Pllc | |
|
88 Village Ln Suite 105 Colleyville TX 76034-2972 | |
| (817) 267-0550 | |
| (817) 545-2368 |
| Full Name | Dan A. Waddell, D.o., Pllc |
|---|---|
| Speciality | Internal Medicine |
| Location | 88 Village Ln, Colleyville, Texas |
| Authorized Official Name and Position | Dan A Waddell (PRESIDENT) |
| Authorized Official Contact | 8172670550 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Dan A. Waddell, D.o., Pllc 88 Village Ln Suite 105 Colleyville TX 76034-2972 Ph: (817) 267-0550 | Dan A. Waddell, D.o., Pllc 88 Village Ln Suite 105 Colleyville TX 76034-2972 Ph: (817) 267-0550 |
| NPI Number | 1265635031 |
|---|---|
| Provider Enumeration Date | 06/07/2007 |
| Last Update Date | 10/20/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1265635031 | NPI | - | NPPES |
| 191097801 | Medicaid | TX | |
| 0028QH | Other | TX | BCBS |
| DN4715 | Other | MEDICARE RAILROAD |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | D7703 (Texas) | Primary |
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