Dan a. Waddell, D.O., PLLC

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

D7703 Issued in TX

Legal business name

DAN A. WADDELL, D.O., PLLC

Practice address

88 Village LN
Suite 105
Colleyville, TX 76034-2972

Phone

(817) 267-0550

Fax

(817) 545-2368

NPI assigned

Jun 7, 2007

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dan A Waddell, D.O.

Title

President

Phone

(817) 267-0550

Specialties & licenses 1

Addresses

Other identifiers 3

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Lydia Michelle Garcia, D.O.

  • Internal Medicine Physician
  • Dallas, TX
  • NPI 1912134602
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1181174400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1224460800000",
    "number": "1265635031",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "88 VILLAGE LN",
            "address_2": "SUITE 105",
            "city": "COLLEYVILLE",
            "state": "TX",
            "postal_code": "760342972",
            "telephone_number": "817-267-0550",
            "fax_number": "817-545-2368"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "88 VILLAGE LN",
            "address_2": "SUITE 105",
            "city": "COLLEYVILLE",
            "state": "TX",
            "postal_code": "760342972",
            "telephone_number": "817-267-0550",
            "fax_number": "817-545-2368"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DAN A. WADDELL, D.O., PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-06-07",
        "last_updated": "2008-10-20",
        "status": "A",
        "authorized_official_last_name": "WADDELL",
        "authorized_official_first_name": "DAN",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "817-267-0550",
        "authorized_official_credential": "D.O."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": "TX",
            "license": "D7703",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "191097801",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "0028QH",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RAILROAD",
            "identifier": "DN4715",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• CR Performance, LLC
• Jaclyn Katie-Jean Crawford
• Kaitlin Cross, MS, LPC
• Eric James Croucher, MSN, APRN, FNP-C
• David William Curtis, DDS
• Daniela Dillman NP PLLC
• Chloe Daugherty
• David D. Kim, MD, PA
• Adaobi Davidson
• Daniel H Davis

• Internal Medicine Physician in Colleyville, TX
• Providers in Colleyville, TX by specialty
• Internal Medicine Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 20, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.