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General NPI Number Information
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NPI Number | 1427462100
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Entity Type | Individual
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Provider Name | NICHOLAS SCOTT LARSON M.D.
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Gender | Male
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Dates
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Enumeration Date | 06/20/2014
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Last Update Date | 07/17/2025
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Provider Practice Location Address
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Address Line | 1700 COGDELL BLVD
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City | SNYDER
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State | TX
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Zip | 79549-6162
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Country | US
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Telephone | 325-573-6374
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Fax |
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Provider Business Mailing Address
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Address Line | 317 SIDNEY BAKER ST S STE 400-227
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City | KERRVILLE
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State | TX
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Zip | 78028-5984
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number | R0442
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number | 141172
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License Number State | AK
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Taxonomy #3
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Taxonomy Code | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number | MD2020-0576
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License Number State | NM
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