MEDICARE: DR. THOMAS DUNCAN NICHOLS MD

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
1	207N00000X	Dermatology Physician	E8765	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1134111347
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. THOMAS DUNCAN NICHOLS MD

Provider Business Mailing Address
First Line	:	2424 W HOLCOMBE BLVD
Second Line	:	SUITE 103
City	:	HOUSTON
State	:	TX
Zip	:	77030-1934
Country	:	US
Telephone Number	:	713-432-7004
Fax Number	:	713-432-7020

Provider Business Practice Location Address
First Line	:	2424 W HOLCOMBE BLVD
Second Line	:	SUITE 103
City	:	HOUSTON
State	:	TX
Zip	:	77030-1934
Country	:	US
Telephone Number	:	713-432-7004
Fax Number	:	713-432-7020

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/16/2005
Last Update Date	:	06/12/2024

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