Provider Demographics
NPI:1982633723
Name:LITTRELL, JOHN N (MD)
Entity Type:Individual
Prefix:
First Name:JOHN
Middle Name:N
Last Name:LITTRELL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:4708 ALLIANCE BLVD
Mailing Address - Street 2:SUITE 270
Mailing Address - City:PLANO
Mailing Address - State:TX
Mailing Address - Zip Code:75093-5340
Mailing Address - Country:US
Mailing Address - Phone:972-758-4990
Mailing Address - Fax:972-758-4991
Practice Address - Street 1:4708 ALLIANCE BLVD
Practice Address - Street 2:SUITE 270
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75093-5340
Practice Address - Country:US
Practice Address - Phone:972-758-4990
Practice Address - Fax:972-758-4991
Is Sole Proprietor?:No
Enumeration Date:2006-07-02
Last Update Date:2023-01-16
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TXL8804208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX169064604Medicaid
TX169064605Medicaid
TX8F8667OtherBCBS
TX169064605Medicaid
TX8K8552Medicare PIN
TX169064604Medicaid