Individual
DR. EDWARD REESE NELSON JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1275 W. TERRELL AVE, STE 200, FORT WORTH, TX 76104-2822
(817) 250-7035
Mailing address
5450 CLEARFORK MAIN ST STE 300, FORT WORTH, TX 76109-3559
(817) 334-1400
(817) 334-1410
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
D8364
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
127910103
—
TX
05
—
127910106
—
TX
Enumeration date
06/12/2006
Last updated
08/14/2023
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