Individual
DANIEL LAWRENCE BLACK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MSN, FNP
Contact information
Practice address
1400 W SW LOOP 323 STE 60, TYLER, TX 75701-7059
(903) 526-4875
Mailing address
110 W ERWIN ST STE B, TYLER, TX 75702-7227
(830) 708-2135
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
AP137811
TX
Other
Enumeration date
06/22/2018
Last updated
10/19/2023
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