Individual
TED CHAN KUMMER JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
FNP
Contact information
Practice address
4545 FULLER DR, SUITE 325, IRVING, TX 75038-6530
(972) 870-5511
(972) 870-5512
Mailing address
PO BOX 1239, TROY, MI 48099-1239
(248) 824-6622
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
739803
TX
363LP2300X
Primary Care Nurse Practitioner
739803
TX
Other
Enumeration date
08/02/2010
Last updated
05/21/2013
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