Individual
DR. WALTER SIMON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
3600 GASTON AVE, WADLEY TOWER, SUITE 261, DALLAS, TX 75246-1800
(214) 818-9100
(214) 818-9180
Mailing address
3600 GASTON AVE, BARNETT TOWER, 707, DALLAS, TX 75246-1800
(214) 823-6492
(214) 818-9180
Taxonomy
Speciality
Code
Description
License number
State
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
K2121
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
047641801
—
TX
01
—
8977K0
BLUE CROSS BLUE SHIELD
TX
Enumeration date
06/28/2006
Last updated
07/29/2010
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