Provider Demographics
NPI:1093553521
Name:WALKER, NOLAN (DDS)
Entity type:Individual
Prefix:
First Name:NOLAN
Middle Name:
Last Name:WALKER
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17225 EL CAMINO REAL STE 150
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77058-2768
Mailing Address - Country:US
Mailing Address - Phone:281-280-9380
Mailing Address - Fax:281-280-9376
Practice Address - Street 1:17225 EL CAMINO REAL STE 150
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77058-2768
Practice Address - Country:US
Practice Address - Phone:281-280-9380
Practice Address - Fax:281-280-9376
Is Sole Proprietor?:No
Enumeration Date:2024-07-18
Last Update Date:2024-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX408161223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice