Nichols, Timothy D

Nichols, Timothy D is an individual health care provider with primary practice located at 12606 Greenville Ave Suite 160, Dallas TX 75243-1921. He recently has 2 registered licenses in different health care specialties including Other Service Providers / Specialist, Allopathic & Osteopathic Physicians / Radiation Oncology. Allopathic & Osteopathic Physicians / Radiation Oncology is his primary health care specialty. Nichols, Timothy D can be contacted via phone (469) 364-7880.

Contact Information

Primary practice address
12606 Greenville Ave Suite 160 Dallas TX 75243-1921
Phone: (469) 364-7880
Fax: (469) 364-7895
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Other Service Providers / Specialist 174400000X J1744 Texas
Allopathic & Osteopathic Physicians / Radiation Oncology 2085R0001X J1744 Texas

Profile Details

NPI number 1093752073
LBN Legal business name Nichols, Timothy D
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date May 31st, 2006
Last updated Mar 23rd, 2021 - about 5 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1093752073 NPPES
Texas MEDICAID 126533203
Texas Other 920003991

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