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General NPI Number Information
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NPI Number | 1982032355
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Entity Type | Individual
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Provider Name | WILLIAM A NICHOLAS
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Gender | Male
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Dates
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Enumeration Date | 10/23/2013
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Last Update Date | 07/21/2025
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Provider Practice Location Address
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Address Line | 576 W INTERSTATE 30
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City | ROYSE CITY
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State | TX
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Zip | 75189-7538
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Country | US
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Telephone | 469-351-0100
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Fax | 469-533-9955
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Provider Business Mailing Address
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Address Line | 576 W INTERSTATE 30
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City | ROYSE CITY
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State | TX
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Zip | 75189-7538
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Country | US
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Telephone | 469-351-0100
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Fax | 469-533-9955
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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 | 363AM0700X
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Taxonomy Name | Medical Physician Assistant
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License Number | PA.0003786
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License Number State | CO
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Taxonomy #2
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | PA09160
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License Number State | TX
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