Individual
NICOLE BUCK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
6606 LBJ FWY, SUITE 200, DALLAS, TX 75240-6533
(972) 715-5000
(972) 715-9976
Mailing address
PO BOX 650865, DALLAS, TX 75265-0865
(972) 715-5000
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
2453
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200505000A
—
OK
05
—
322078202
—
TX
01
—
8777UG
BCBS
TX
Enumeration date
03/13/2013
Last updated
10/05/2015
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