Organization
SURGICAL RESOLUTIONS PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KEVIN WAYNE NIBLETT M.D. (PHYSICIAN)
(972) 283-2244
Entity
Organization
Contact information
Practice address
921 YORK DR, DESOTO, TX 75115-2043
(972) 283-2244
(972) 283-2246
Mailing address
921 YORK DR, DESOTO, TX 75115-2043
(972) 283-2244
(972) 283-2246
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
J3706
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
105633503
—
TX
Enumeration date
04/16/2009
Last updated
06/16/2009
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