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General NPI Number Information
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NPI Number | 1760977292
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Entity Type | Individual
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Provider Name | NICKESH MISTRY DC
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Gender | Male
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Dates
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Enumeration Date | 06/27/2018
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Last Update Date | 08/19/2024
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Provider Practice Location Address
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Address Line | 1061 N PRESTON RD
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City | CELINA
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State | TX
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Zip | 75009-3800
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Country | US
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Telephone | 469-826-7339
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Fax |
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Provider Business Mailing Address
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Address Line | 13486 HEMLOCK TRL
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City | FRISCO
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State | TX
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Zip | 75035-0040
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Country | US
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Telephone | 469-826-7339
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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 | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | 13727
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License Number State | TX
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