Provider Demographics
NPI:1184018681
Name:TENZEL, NICOLE SARA (MD)
Entity Type:Individual
Prefix:DR
First Name:NICOLE
Middle Name:SARA
Last Name:TENZEL
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:NICOLE
Other - Middle Name:SARA
Other - Last Name:MANDEL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3836 CREST COVE CIR
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75244-7224
Mailing Address - Country:US
Mailing Address - Phone:561-706-5552
Mailing Address - Fax:
Practice Address - Street 1:3201 MATLOCK RD STE 220
Practice Address - Street 2:
Practice Address - City:ARLINGTON
Practice Address - State:TX
Practice Address - Zip Code:76015-2947
Practice Address - Country:US
Practice Address - Phone:682-282-6648
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-03-23
Last Update Date:2022-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME148432207V00000X
390200000X
TXS1290207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program