MEDICARE: NIKKI WAQAS

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	224Z00000X	Occupational Therapy Assistant	211408	TX

General Provider Information

NPI Number	:	1326721911
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	NIKKI WAQAS

Provider Business Mailing Address
First Line	:	245 FM 1488 RD APT 2007
Second Line	:
City	:	CONROE
State	:	TX
Zip	:	77384-3957
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	7950 BAY BRANCH DR
Second Line	:
City	:	THE WOODLANDS
State	:	TX
Zip	:	77382-5317
Country	:	US
Telephone Number	:	281-681-8000
Fax Number	:

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

Provider Enumeration Date	:	08/09/2023
Last Update Date	:	08/09/2023

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Directions to “ NIKKI WAQAS ” Practice Location

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