Individual
DR. NICK FRANK MUSSO JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1650 W COLLEGE ST, GRAPEVINE, TX 76051-3565
(817) 329-2502
Mailing address
1650 W COLLEGE ST, GRAPEVINE, TX 76051-3565
(817) 329-2502
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
J0891
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
135838414
—
TX
Enumeration date
02/16/2007
Last updated
08/03/2011
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