Provider Demographics
NPI:1033360425
Name:DAVID NICHOLS
Entity Type:Organization
Organization Name:DAVID NICHOLS
Other - Org Name:ALL-NITE SLEEP LAB
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:C
Authorized Official - Last Name:NICHOLS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:903-383-2899
Mailing Address - Street 1:606 E GOODE ST
Mailing Address - Street 2:# 400
Mailing Address - City:QUITMAN
Mailing Address - State:TX
Mailing Address - Zip Code:75783-2567
Mailing Address - Country:US
Mailing Address - Phone:903-763-4709
Mailing Address - Fax:903-383-2893
Practice Address - Street 1:606 E GOODE ST
Practice Address - Street 2:# 400
Practice Address - City:QUITMAN
Practice Address - State:TX
Practice Address - Zip Code:75783-2567
Practice Address - Country:US
Practice Address - Phone:903-763-4709
Practice Address - Fax:903-383-2893
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-10-04
Last Update Date:2008-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RS0012XAllopathic & Osteopathic PhysiciansInternal MedicineSleep MedicineGroup - Multi-Specialty