Provider Demographics
NPI:1407299761
Name:NELSON, DAVID BENJAMIN (MD)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:BENJAMIN
Last Name:NELSON
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5323 HARRY HINES BLVD STOP 8879
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75390-8879
Mailing Address - Country:US
Mailing Address - Phone:214-645-7700
Mailing Address - Fax:
Practice Address - Street 1:5323 HARRY HINES BLVD STOP 8879
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75390-4000
Practice Address - Country:US
Practice Address - Phone:214-645-7700
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-04-16
Last Update Date:2023-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXR0083208G00000X, 208600000X, 208G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208G00000XAllopathic & Osteopathic PhysiciansThoracic Surgery (Cardiothoracic Vascular Surgery)
No208600000XAllopathic & Osteopathic PhysiciansSurgery