Individual
THOMAS WALTER WALKIEWICZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
8440 WALNUT HILL LN, STE 510, DALLAS, TX 75231-3833
(866) 805-6711
(214) 345-5543
Mailing address
815 PENNSYLVANIA AVE, STE 510, FORT WORTH, TX 76104-2224
(817) 321-0937
Taxonomy
Speciality
Code
Description
License number
State
2085N0700X
Neuroradiology Physician
N6761
TX
2085R0202X
Diagnostic Radiology Physician
Primary
N6761
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
145J0
BCBS
—
Enumeration date
01/11/2007
Last updated
02/29/2016
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