Individual
JEFFREY M NOWAK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
NP
Contact information
Practice address
7777 FOREST LN STE 400, DALLAS, TX 75230-2571
(972) 566-7790
(972) 566-5819
Mailing address
PO BOX 911230, DALLAS, TX 75391-1230
(972) 997-8000
(972) 234-0813
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
658745
TX
363LA2100X
Acute Care Nurse Practitioner
658745
TX
363LA2100X
Acute Care Nurse Practitioner
Primary
AP112695
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
171609401
—
TX
05
—
171609402
—
TX
05
—
171609403
—
TX
05
—
171609407
—
TX
Enumeration date
06/27/2006
Last updated
04/20/2016
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