Organization
NELSON D DESTAFFANY MD PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. NELSON D DESTAFFANY M.D. (PRESIDENT)
(254) 776-0266
Entity
Organization
Contact information
Practice address
405 LONDONDERRY DR, SUITE 105, WACO, TX 76712-7924
(254) 776-0266
(254) 776-2511
Mailing address
405 LONDONDERRY DR, SUITE 105, WACO, TX 76712-7924
(254) 776-0266
(254) 776-2511
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
F3902
TX
Other
Enumeration date
10/11/2005
Last updated
08/22/2020
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