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Russ Todd Nelson, LPT
Specialist in Texarkana, Texas
NPI 1407841695

Russ Todd Nelson is a Specialist based in Texarkana, TX. Russ Todd Nelson practices in Texarkana, TX and has the professional credentials of LPT. The NPI Number for Russ Todd Nelson is 1407841695 and holds a License No. 1090942 (Texas).

The current practice location address for Russ Todd Nelson is 4303 Texas Blvd, Texarkana, TX and can be reached out via phone at 903-793-1797 and via fax at 903-793-2105.

Location: 4303 Texas Blvd, Texarkana, TX, 75503-3097
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1407841695
Provider Name
Russ Todd Nelson
Credential
LPT
Provider Entity Type
Individual
Gender
Male
Address
4303 Texas Blvd, Texarkana, TX, 75503-3097
Phone Number
903-793-1797
Fax Number
903-793-2105
Provider Enumeration Date
09/14/2005
Last Update Date
03/08/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
1090942 01 TX TX LICENSE
99451 01 AR AR BCBS NUMBER
86940T 01 TX BCBS ID NUMBER
institution
Provider Business Practice Location Address Details
Address
4303 Texas Blvd
City
Texarkana
State
Texas
Zip
75503-3097
Phone Number
903-793-1797
Fax Number
903-793-2105
person
Provider Business Mailing Address Details
Address
4303 Texas Blvd
City
Texarkana
State
Texas
Zip
75503-3097
Phone Number
903-793-1797
Fax Number
903-793-2105
person
Provider's Taxonomy Details 1
Type
Other Service Providers
Classification
Specialist
Speciality
-
Taxonomy
174400000X
License No.
1090942 (Texas)
Definition
An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree.
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