Provider Demographics
NPI: | 1922073048 |
---|---|
Name: | HOWARD, NATHAN S (MD) |
Entity type: | Individual |
Prefix: | |
First Name: | NATHAN |
Middle Name: | S |
Last Name: | HOWARD |
Suffix: | |
Gender: | M |
Credentials: | MD |
Other - Prefix: | |
Other - First Name: | |
Other - Middle Name: | |
Other - Last Name: | |
Other - Suffix: | |
Other - Last Name Type: | |
Other - Credentials: | |
Mailing Address - Street 1: | 820 W ARAPAHO RD STE 200 |
Mailing Address - Street 2: | |
Mailing Address - City: | RICHARDSON |
Mailing Address - State: | TX |
Mailing Address - Zip Code: | 75080-4065 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 972-498-4500 |
Mailing Address - Fax: | 972-680-9147 |
Practice Address - Street 1: | 820 W ARAPAHO RD STE 200 |
Practice Address - Street 2: | |
Practice Address - City: | RICHARDSON |
Practice Address - State: | TX |
Practice Address - Zip Code: | 75080-4065 |
Practice Address - Country: | US |
Practice Address - Phone: | 972-498-4500 |
Practice Address - Fax: | 972-680-9147 |
Is Sole Proprietor?: | No |
Enumeration Date: | 2006-02-22 |
Last Update Date: | 2025-10-02 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Licenses
State | License ID | Taxonomies |
---|---|---|
CA | A75819 | 207Q00000X |
TX | V3883 | 207Q00000X |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization |
---|---|---|---|---|
Yes | 207Q00000X | Allopathic & Osteopathic Physicians | Family Medicine |
Provider Identifiers
State | Identifier ID | ID Type | Issuer |
---|---|---|---|
CA | 11467027 | Other | CAQH |
CA | H64255 | Medicare UPIN | |
CA | 11467027 | Other | CAQH |
CA | H64255 | Medicare UPIN | |
CA | ZZZ01550Z | Medicare ID - Type Unspecified | MCR TEMECULA LOCATION |