Provider Demographics
NPI:1811132970
Name:MORRISON, DARREL (NP)
Entity type:Individual
Prefix:MR
First Name:DARREL
Middle Name:
Last Name:MORRISON
Suffix:
Gender:M
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1717 MAIN ST
Mailing Address - Street 2:STE 5200
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75201-4612
Mailing Address - Country:US
Mailing Address - Phone:214-712-2000
Mailing Address - Fax:214-712-2444
Practice Address - Street 1:3500 GASTON AVE
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75246-2017
Practice Address - Country:US
Practice Address - Phone:214-712-2000
Practice Address - Fax:214-712-2444
Is Sole Proprietor?:No
Enumeration Date:2008-12-03
Last Update Date:2017-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX677949363L00000X
TXAP117625363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX200708017Medicaid
TX320948YM09Medicare PIN