Individual
DR. JAMES DAVID RUSSELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
4716 ALLIANCE BLVD, SUITE 150, PLANO, TX 75093-5371
(469) 467-6647
(469) 467-6648
Mailing address
4716 ALLIANCE BLVD, SUITE 150, PLANO, TX 75093-5371
(469) 467-6647
(469) 467-6648
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Q7954
TX
207ND0101X
MOHS-Micrographic Surgery Physician
Primary
Q7954
TX
390200000X
Student in an Organized Health Care Education/Training Program
—
VA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
03/29/2011
Last updated
06/27/2016
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