Healthcare Provider Details

I. General information

NPI: 1073042461
Provider Name (Legal Business Name): NICOLAS C PUGH MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/08/2017
Last Update Date: 12/19/2025
Certification Date: 12/19/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1925 HOSPITAL PL
ABILENE TX
79606-5239
US

IV. Provider business mailing address

1925 HOSPITAL PL
ABILENE TX
79606-5239
US

V. Phone/Fax

Practice location:
  • Phone: 325-326-3433
  • Fax: 325-378-9175
Mailing address:
  • Phone: 325-326-3433
  • Fax: 325-378-9175

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208VP0000X
TaxonomyPain Medicine Physician
License NumberU4314
License Number StateTX
# 2
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number323201
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: