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NPI Code Detail

MEDICARE: NIKIA A AUTRY

MEDICARE: NIKIA A AUTRY
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
1246RP1900XPhlebotomy TechnicianM6G2E8J4TX
21744P3200XProsthetics Case Management
3224900000XMastectomy Fitter
4332B00000XDurable Medical Equipment & Medical Supplies

General Provider Information

NPI Number : 1992275770
Entity Type Code : Individual
Provider Name (Legal Business Name) : NIKIA A AUTRY
Provider Business Mailing Address
First Line : 3626 N HALL ST STE 610
Second Line :
City : DALLAS
State : TX
Zip : 75219-5131
Country : US
Telephone Number : 866-301-1456
Fax Number :
Provider Business Practice Location Address
First Line : 3626 N HALL ST STE 610
Second Line :
City : DALLAS
State : TX
Zip : 75219-5131
Country : US
Telephone Number : 866-301-1456
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/05/2018
Last Update Date : 10/24/2024

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Directions to “ NIKIA A AUTRY ” 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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