MEDICARE: NUCH OF TEXAS

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy
1	208000000X	Pediatrics Physician
2	207P00000X	Emergency Medicine Physician
3	207Q00000X	Family Medicine Physician
4	208D00000X	General Practice Physician
5	207R00000X	Internal Medicine Physician
6	363L00000X	Nurse Practitioner
7	363LF0000X	Family Nurse Practitioner
8	363A00000X	Physician Assistant
9	261QU0200X	Urgent Care Clinic/Center

General Provider Information

NPI Number	:	1720451776
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	NUCH OF TEXAS

Provider Business Mailing Address
First Line	:	160 CREEKSIDE WAY
Second Line	:	SUITE 602
City	:	NEW BRAUNFELS
State	:	TX
Zip	:	78130-6396
Country	:	US
Telephone Number	:	830-387-5330
Fax Number	:	830-387-5389

Provider Business Practice Location Address
First Line	:	160 CREEKSIDE WAY
Second Line	:	SUITE 602
City	:	NEW BRAUNFELS
State	:	TX
Zip	:	78130-6396
Country	:	US
Telephone Number	:	830-387-5330
Fax Number	:	830-387-5389

Authorized Official
Title or Position	:	SVP, OUTPATIENT SERVICES, TENET
Name	:	MR. MICHAEL KYLE BAILEY
Credential	:
Telephone Number	:	469-893-2902

Provider Enumeration Date	:	11/12/2015
Last Update Date	:	04/24/2017

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Directions to “NUCH OF TEXAS ” Practice Location

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