Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Mr. Jack Robert Thurman, NURSEPRACTITIONER

Individual provider Acute Care Nurse Practitioner · NPI 1063091676

Mr. Jack Robert Thurman, NURSEPRACTITIONER is a Nurse Practitioner in Dallas, Texas. Qualified in 2020, 6 years ago. Practices with Providence Health Alliance, a 122-clinician group, accepts Medicare assignment and offers telehealth. Licensed in Texas.

Years since qualifying
6
Licensed in
TX
In the registry since
2021
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Practice location Address checks out

9839 Elmcrest Dr
Dallas, TX 75238-1831
Phone: (214) 335-9717
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Acute Care Nurse Practitioner (primary) Taxonomy 363LA2100X · Licence 1032756 (TX)

Record details

NPI number1063091676
Entity typeIndividual (Type 1)
GenderMale
Credentials NURSEPRACTITIONER
Sole proprietorNo
NPI enumeratedApril 2, 2021
Last updated in NPPESApril 2, 2021
Certification dateApril 2, 2021

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2020 (6 years in practice)
Group practice Providence Health Alliance — 122 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
TelehealthOffers telehealth services
Practice locations3 on file with Medicare

Other providers in Dallas