Provider Demographics
NPI:1215370747
Name:MAYS, NICOLE
Entity Type:Individual
Prefix:
First Name:NICOLE
Middle Name:
Last Name:MAYS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18318 ENCHANTED ROCK TRL
Mailing Address - Street 2:
Mailing Address - City:HUMBLE
Mailing Address - State:TX
Mailing Address - Zip Code:77346-3409
Mailing Address - Country:US
Mailing Address - Phone:713-594-0469
Mailing Address - Fax:713-594-0469
Practice Address - Street 1:340 N SAM HOUSTON PKWY E STE 247
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77060-3325
Practice Address - Country:US
Practice Address - Phone:713-594-0469
Practice Address - Fax:713-583-0900
Is Sole Proprietor?:Yes
Enumeration Date:2013-04-15
Last Update Date:2021-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320600000XResidential Treatment FacilitiesResidential Treatment Facility, Intellectual and/or Developmental Disabilities
No320900000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities