Organization
NIKKI A WALDEN MD PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MIKE WALDEN (OFFICE MANAGER)
(972) 820-9333
Entity
Organization
Contact information
Practice address
4325 N JOSEY LN, 300, CARROLLTON, TX 75010-4635
(972) 820-9333
Mailing address
PO BOX 118383, CARROLLTON, TX 75011-8383
(972) 820-9333
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
L8999
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0066MH
BLUE CROSS BLUE SHIELD
TX
01
—
16244
PARKLAND
TX
05
—
173131701
—
TX
01
—
4501037598
CLIA
TX
01
—
4732959
CIGNA
TX
Enumeration date
06/24/2008
Last updated
06/24/2008
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