Provider Demographics
NPI:1215004981
Name:ADAME, NICHOLAS L (DC)
Entity Type:Individual
Prefix:DR
First Name:NICHOLAS
Middle Name:L
Last Name:ADAME
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6318 SENATORS DR
Mailing Address - Street 2:
Mailing Address - City:CORPUS CHRISTI
Mailing Address - State:TX
Mailing Address - Zip Code:78413-2516
Mailing Address - Country:US
Mailing Address - Phone:361-658-6982
Mailing Address - Fax:
Practice Address - Street 1:2727 MORGAN AVE
Practice Address - Street 2:STE. #200
Practice Address - City:CORPUS CHRISTI
Practice Address - State:TX
Practice Address - Zip Code:78405-1821
Practice Address - Country:US
Practice Address - Phone:361-884-4878
Practice Address - Fax:361-884-6266
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX8018111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX605938OtherBLUE CROSS BLUE SHIELD
TX605938OtherBLUE CROSS BLUE SHIELD
TX609419Medicare ID - Type Unspecified