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NPI Code Detail

MEDICARE: DR. NICOLE MARIE SHUTKO D.C.

MEDICARE:  DR. NICOLE MARIE SHUTKO  D.C.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1111NR0400XRehabilitation Chiropractor8742TX

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
18AK973OTHERTXBCBS

General Provider Information

NPI Number : 1083804355
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. NICOLE MARIE SHUTKO D.C.
Provider Business Mailing Address
First Line : 3910 KIRBY DR
Second Line : STE 212
City : HOUSTON
State : TX
Zip : 77098-4120
Country : US
Telephone Number : 713-522-2886
Fax Number : 713-522-2738
Provider Business Practice Location Address
First Line : 3910 KIRBY DR
Second Line : STE 212
City : HOUSTON
State : TX
Zip : 77098-4120
Country : US
Telephone Number : 713-522-2886
Fax Number : 713-522-2738
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/01/2007
Last Update Date : 02/12/2025

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Directions to “ DR. NICOLE MARIE SHUTKO D.C.” Practice Location

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