MEDICARE: DR. SAMANTHA ASHLEY NICKELSON DC

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	111N00000X	Chiropractor	16578	TX

General Provider Information

NPI Number	:	1982581245
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. SAMANTHA ASHLEY NICKELSON DC

Provider Business Mailing Address
First Line	:	1504 PACO TRL
Second Line	:
City	:	DENTON
State	:	TX
Zip	:	76209-4644
Country	:	US
Telephone Number	:	940-435-1164
Fax Number	:	940-213-1601

Provider Business Practice Location Address
First Line	:	1504 PACO TRL
Second Line	:
City	:	DENTON
State	:	TX
Zip	:	76209-4644
Country	:	US
Telephone Number	:	940-435-1164
Fax Number	:	940-213-1601

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

Provider Enumeration Date	:	08/19/2025
Last Update Date	:	03/06/2026

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Directions to “ DR. SAMANTHA ASHLEY NICKELSON DC” Practice Location

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