Nathan Sumarsono
Nathan Sumarsono is a Student in an Organized Health Care Education/Training Program in Dallas, Texas. Practices as a sole proprietor. Registered with an NPI since 2020.
- In the registry since
- 2020
Practice location Address checks out
5323 Harry Hines BlvdDallas, TX 75390-7201
Phone: (214) 648-2168
Fax: (214) 648-7517
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Pin is approximate — placed at the ZIP-code centre, not the exact door.
Specialties & licences
| Student in an Organized Health Care Education/Training Program (primary) | Taxonomy 390200000X |
|---|
Record details
| NPI number | 1063022408 |
|---|---|
| Entity type | Individual (Type 1) |
| Gender | Male |
| Sole proprietor | Yes |
| NPI enumerated | July 31, 2020 |
| Last updated in NPPES | July 31, 2020 |
| Certification date | July 31, 2020 |
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