MEDICARE: MR. WILLIAM ROBERT NICHOLS JR.

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	174H00000X	Health Educator

General Provider Information

NPI Number	:	1568321289
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. WILLIAM ROBERT NICHOLS JR.

Provider Business Mailing Address
First Line	:	PO BOX 293794
Second Line	:
City	:	KERRVILLE
State	:	TX
Zip	:	78029-3794
Country	:	US
Telephone Number	:	830-928-2625
Fax Number	:

Provider Business Practice Location Address
First Line	:	1225 BANDERA HWY STE B5
Second Line	:
City	:	KERRVILLE
State	:	TX
Zip	:	78028-9676
Country	:	US
Telephone Number	:	830-928-2625
Fax Number	:

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

Provider Enumeration Date	:	01/19/2026
Last Update Date	:	01/19/2026

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