Provider Demographics
NPI:1407889181
Name:NALEY, ROLF K (MD)
Entity Type:Individual
Prefix:DR
First Name:ROLF
Middle Name:K
Last Name:NALEY
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 1:836 CANYON CREST DR
Mailing Address - Street 2:
Mailing Address - City:IRVING
Mailing Address - State:TX
Mailing Address - Zip Code:75063-4669
Mailing Address - Country:US
Mailing Address - Phone:214-616-3395
Mailing Address - Fax:
Practice Address - Street 1:836 CANYON CREST DR
Practice Address - Street 2:
Practice Address - City:IRVING
Practice Address - State:TX
Practice Address - Zip Code:75063-4669
Practice Address - Country:US
Practice Address - Phone:214-616-3395
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-08
Last Update Date:2011-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXK3353207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX081036801OtherMEDICAID GROUP #
TX0070AUOtherMEDICARE GROUP #
TXC63872Medicare UPIN