Individual
DR. NICHOLAS GREGORY IWASKO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
4420 CEDARBRUSH DR, DALLAS, TX 75229-2901
(352) 222-7431
(972) 542-6915
Mailing address
4420 CEDARBRUSH DR, DALLAS, TX 75229-2901
(352) 222-7431
(972) 542-6915
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
L3347
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
35-07-8584-I
MEDICAL LICENSE NUMBER
OH
01
—
43010774455
MEDICAL LICENSE NUMBER
MI
01
—
AO68320
MEDICAL LICENSE NUMBER
CA
01
—
L3347
MEDICAL LICENSE NUMBER
TX
01
—
ME-0073118
MEDICAL LICENSE NUMBER
FL
Enumeration date
07/30/2006
Last updated
11/10/2021
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