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General NPI Number Information
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NPI Number | 1750686556
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Entity Type | Individual
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Provider Name | NICOLE LANCASTER GREGORY OTR
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Gender | Female
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Dates
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Enumeration Date | 01/26/2011
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Last Update Date | 11/16/2023
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Provider Practice Location Address
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Address Line | 350 VISTA COURT DRIVE APT 2304
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City | PLANO
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State | TX
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Zip | 75074
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Country | US
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Telephone | 945-271-5026
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Fax | 903-535-7384
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Provider Business Mailing Address
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Address Line | 350 VISTA COURT DRIVE APT 2304
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City | PLANO
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State | TX
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Zip | 75074
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Country | US
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Telephone | 945-271-5026
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Fax | 903-535-7384
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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 | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number | 113983
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License Number State | TX
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