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NPI Code Detail

MEDICARE: NICHOLAS TERENCE VANKKA

MEDICARE: NICHOLAS TERENCE VANKKA
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
1390200000XStudent in an Organized Health Care Education/Training ProgramTX

General Provider Information

NPI Number : 1801741368
Entity Type Code : Individual
Provider Name (Legal Business Name) : NICHOLAS TERENCE VANKKA
Provider Business Mailing Address
First Line : 13820 E GERONIMO RD
Second Line :
City : SCOTTSDALE
State : AZ
Zip : 85259-2227
Country : US
Telephone Number : 780-222-9230
Fax Number :
Provider Business Practice Location Address
First Line : 5200 HARRY HINES BLVD
Second Line :
City : DALLAS
State : TX
Zip : 75235-7709
Country : US
Telephone Number : 214-590-8000
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/02/2026
Last Update Date : 03/02/2026

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Directions to “ NICHOLAS TERENCE VANKKA ” Practice Location

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These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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