Individual
NATHANIEL GRAHAM LANE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
6451 BRENTWOOD STAIR RD STE 200, FORT WORTH, TX 76112
(720) 201-9397
Mailing address
6505 WEST PARK BLVD. STE. 306 PMB # 514, PLANO, TX 75093
(720) 201-9397
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
Q5847
TX
Other
Enumeration date
02/02/2011
Last updated
05/25/2018
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