Provider Demographics
NPI:1912215609
Name:ORR, NATHAN TERRY (MD)
Entity Type:Individual
Prefix:DR
First Name:NATHAN
Middle Name:TERRY
Last Name:ORR
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:621 N HALL ST STE 100
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75226-1305
Mailing Address - Country:US
Mailing Address - Phone:214-821-9600
Mailing Address - Fax:214-823-5290
Practice Address - Street 1:621 N HALL ST STE 100
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75226-1305
Practice Address - Country:US
Practice Address - Phone:214-821-9600
Practice Address - Fax:214-823-5290
Is Sole Proprietor?:No
Enumeration Date:2010-09-16
Last Update Date:2022-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY46742208600000X, 2086S0129X
TXS80892086S0129X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086S0129XAllopathic & Osteopathic PhysiciansSurgeryVascular Surgery
No208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY46742OtherLICENSE