Provider Demographics
NPI:1609153220
Name:NELSON, DON (ATP)
Entity Type:Individual
Prefix:MR
First Name:DON
Middle Name:
Last Name:NELSON
Suffix:
Gender:M
Credentials:ATP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2436 S I-35 E
Mailing Address - Street 2:SUITE 346
Mailing Address - City:DENTON
Mailing Address - State:TX
Mailing Address - Zip Code:76205-4992
Mailing Address - Country:US
Mailing Address - Phone:940-380-0455
Mailing Address - Fax:940-382-3026
Practice Address - Street 1:2436 S I-35 E
Practice Address - Street 2:SUITE 346
Practice Address - City:DENTON
Practice Address - State:TX
Practice Address - Zip Code:76205-4992
Practice Address - Country:US
Practice Address - Phone:940-380-0455
Practice Address - Fax:940-382-3026
Is Sole Proprietor?:No
Enumeration Date:2011-11-10
Last Update Date:2011-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXATP 3436225CA2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225CA2500XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRehabilitation CounselorAssistive Technology Supplier
Provider Identifiers
StateIdentifier IDID TypeIssuer
ATP 3436OtherATP