MEDICARE: NICOLE MARIE STOLLE PT

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	225100000X	Physical Therapist	1234663	TX

General Provider Information

NPI Number	:	1881027423
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	NICOLE MARIE STOLLE PT

Provider Business Mailing Address
First Line	:	2840 COMMERCIAL CENTER BLVD
Second Line	:	SUITE 103
City	:	KATY
State	:	TX
Zip	:	77494-6411
Country	:	US
Telephone Number	:	281-693-1063
Fax Number	:	281-693-1081

Provider Business Practice Location Address
First Line	:	2840 COMMERCIAL CENTER BLVD
Second Line	:	SUITE 103
City	:	KATY
State	:	TX
Zip	:	77494-6411
Country	:	US
Telephone Number	:	281-693-1063
Fax Number	:	281-693-1081

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

Provider Enumeration Date	:	08/19/2013
Last Update Date	:	08/19/2013

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Directions to “ NICOLE MARIE STOLLE PT” Practice Location

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