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1225028491

NPI Code Detail

MEDICARE: DR. JOSE MIGUEL NOLLA MD

MEDICARE: DR. JOSE MIGUEL NOLLA MD

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
1	207X00000X	Orthopaedic Surgery Physician	M2732	TX
2	207XS0106X	Orthopaedic Hand Surgery Physician	M2732	TX
3	2086S0105X	Surgery of the Hand (Surgery) Physician	M2732	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	8P5576	OTHER	TX	BCBS TEXAS
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1225028491
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JOSE MIGUEL NOLLA MD

Provider Business Mailing Address
First Line	:	11511 SHADOW CREEK PKWY
Second Line	:
City	:	PEARLAND
State	:	TX
Zip	:	77584-7298
Country	:	US
Telephone Number	:	713-442-0000
Fax Number	:

Provider Business Practice Location Address
First Line	:	2727 W HOLCOMBE BLVD
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77025-1669
Country	:	US
Telephone Number	:	713-442-0000
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/27/2005
Last Update Date	:	04/28/2020

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Directions to “ DR. JOSE MIGUEL NOLLA MD” Practice Location

Language	Start Address	Practice Location

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