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NPI Code Detail

MEDICARE: NICHOLAS LEE NEWLAND MS

MEDICARE: NICHOLAS LEE NEWLAND MS
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
1101YM0800XMental Health Counselor87051TX

General Provider Information

NPI Number : 1295407492
Entity Type Code : Individual
Provider Name (Legal Business Name) : NICHOLAS LEE NEWLAND MS
Provider Business Mailing Address
First Line : 633 E FERNHURST DR STE 1102
Second Line :
City : KATY
State : TX
Zip : 77450-1592
Country : US
Telephone Number : 281-940-8515
Fax Number :
Provider Business Practice Location Address
First Line : 633 E FERNHURST DR STE 1102
Second Line :
City : KATY
State : TX
Zip : 77450-1592
Country : US
Telephone Number : 281-940-8515
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/05/2021
Last Update Date : 10/05/2021

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Directions to “ NICHOLAS LEE NEWLAND MS” Practice Location

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