MEDICARE: NUCH OF TEXAS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy
1	363LF0000X	Family Nurse Practitioner
2	207P00000X	Emergency Medicine Physician
3	207Q00000X	Family Medicine Physician
4	207R00000X	Internal Medicine Physician
5	208D00000X	General Practice Physician
6	363A00000X	Physician Assistant
7	363L00000X	Nurse Practitioner
8	261QU0200X	Urgent Care Clinic/Center

General Provider Information

NPI Number	:	1588115935
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	NUCH OF TEXAS

Provider Business Mailing Address
First Line	:	115 EASTPARK DRIVE STE 300
Second Line	:
City	:	BRENTWOOD
State	:	TN
Zip	:	37027-2311
Country	:	US
Telephone Number	:	615-602-4102
Fax Number	:	615-309-8341

Provider Business Practice Location Address
First Line	:	155 WONDER WORLD DRIVE
Second Line	:
City	:	SAN MARCOS
State	:	TX
Zip	:	78666-7697
Country	:	US
Telephone Number	:	512-738-8334
Fax Number	:	512-738-8335

Authorized Official
Title or Position	:	AUTHORIZED SIGNATORY
Name	:	MR. ERIC ENDERLE
Credential	:
Telephone Number	:	615-600-4120

Provider Enumeration Date	:	10/20/2016
Last Update Date	:	08/15/2017

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Directions to “NUCH OF TEXAS ” Practice Location

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