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General NPI Number Information
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NPI Number | 1851808513
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Entity Type | Individual
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Provider Name | NICHELLE BANAG PACIA ND
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Gender | Female
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Dates
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Enumeration Date | 01/03/2018
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Last Update Date | 12/06/2018
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Provider Practice Location Address
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Address Line | 26440 FM 1093 RD STE 350
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City | RICHMOND
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State | TX
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Zip | 77406-7200
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Country | US
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Telephone | 832-987-4831
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Fax |
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Provider Business Mailing Address
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Address Line | 12911 BONNIE LN
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City | STAFFORD
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State | TX
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Zip | 77477-4563
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Country | US
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Telephone | 832-293-0703
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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 | 175F00000X
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Taxonomy Name | Naturopath
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License Number | 0002
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License Number State | NH
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