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NPI Code Detail

MEDICARE: DR. WESLEY SCOTT NICKENS M.D.

MEDICARE: DR. WESLEY SCOTT NICKENS M.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207Q00000XFamily Medicine PhysicianN2217TX

General Provider Information

NPI Number : 1043405913
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. WESLEY SCOTT NICKENS M.D.
Provider Business Mailing Address
First Line : 2501 LAKEVIEW DR
Second Line :
City : AMARILLO
State : TX
Zip : 79109-1531
Country : US
Telephone Number : 806-355-8900
Fax Number : 806-355-2453
Provider Business Practice Location Address
First Line : 2701 S GEORGIA ST
Second Line :
City : AMARILLO
State : TX
Zip : 79109-1979
Country : US
Telephone Number : 806-350-8980
Fax Number : 806-350-7573
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/12/2007
Last Update Date : 05/05/2022

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