MEDICARE: BUFORD 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	2080P0206X	Pediatric Gastroenterology Physician	D1475	TX

General Provider Information

NPI Number	:	1578643987
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BUFORD NICHOLS MD

Provider Business Mailing Address
First Line	:	6701 FANNIN ST
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77030-2316
Country	:	US
Telephone Number	:	832-822-2778
Fax Number	:	832-825-4131

Provider Business Practice Location Address
First Line	:	6701 FANNIN ST
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77030-2316
Country	:	US
Telephone Number	:	832-822-2778
Fax Number	:	832-825-4131

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

Provider Enumeration Date	:	10/17/2006
Last Update Date	:	01/25/2026

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