Individual
NOLAN SCOTT MALTHESEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
6311 SOUTHWEST BLVD, BENBROOK, TX 76132-1063
(817) 731-9400
(817) 731-4282
Mailing address
6311 SOUTHWEST BLVD, BENBROOK, TX 76132-1063
(817) 731-9400
(817) 731-4282
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
N8120
TX
207XX0005X
Sports Medicine (Orthopaedic Surgery) Physician
N8120
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
8V9723
BCBSTX
TX
Enumeration date
10/23/2007
Last updated
07/23/2012
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