Provider Demographics
NPI:1225057854
Name:MCGINTY, NICOLE (MD)
Entity Type:Individual
Prefix:DR
First Name:NICOLE
Middle Name:
Last Name:MCGINTY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3121 BUFFALO SPEEDWAY
Mailing Address - Street 2:# 3402
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77098-1971
Mailing Address - Country:US
Mailing Address - Phone:713-305-6533
Mailing Address - Fax:
Practice Address - Street 1:3121 BUFFALO SPEEDWAY
Practice Address - Street 2:# 3402
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77098-1971
Practice Address - Country:US
Practice Address - Phone:713-305-6533
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-18
Last Update Date:2013-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXK0522207Q00000X, 207QA0505X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No207QA0505XAllopathic & Osteopathic PhysiciansFamily MedicineAdult Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX0312803-01TMedicaid
TX00863JMedicare ID - Type Unspecified
TX0312803-01TMedicaid