Individual
CARL L RUSSELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
331 MELROSE DR, SUITE 220, RICHARDSON, TX 75080
(469) 828-1903
(469) 374-3851
Mailing address
275 W CAMPBELL ROAD SUITE 260, RICHARDSON, TX 75080
(214) 932-1860
(214) 234-2762
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
L3808
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
150821001
—
TX
05
—
150821002
—
TX
05
—
150821003
—
TX
Enumeration date
06/29/2006
Last updated
04/24/2025
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