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NPI Code Detail

MEDICARE: DR. DIANNE NICHOLAS M.D.

MEDICARE:  DR. DIANNE  NICHOLAS  M.D.
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
1207P00000XEmergency Medicine PhysicianJ2238TX
2207R00000XInternal Medicine PhysicianJ2238TX

General Provider Information

NPI Number : 1679553499
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. DIANNE NICHOLAS M.D.
Provider Business Mailing Address
First Line : PO BOX 14231
Second Line :
City : HOUSTON
State : TX
Zip : 77221-4231
Country : US
Telephone Number : 713-440-0602
Fax Number : 713-944-8903
Provider Business Practice Location Address
First Line : 5160 TIMBER CREEK DR
Second Line :
City : HOUSTON
State : TX
Zip : 77017-5968
Country : US
Telephone Number : 713-440-0602
Fax Number : 713-944-8903
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/18/2006
Last Update Date : 08/28/2009

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Directions to “ DR. DIANNE NICHOLAS M.D.” Practice Location

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