Provider Demographics
NPI:1225320625
Name:NICOLETTI, BRIANNE THERESA (DO)
Entity Type:Individual
Prefix:
First Name:BRIANNE
Middle Name:THERESA
Last Name:NICOLETTI
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 802772
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75380-2772
Mailing Address - Country:US
Mailing Address - Phone:972-484-7700
Mailing Address - Fax:972-484-7718
Practice Address - Street 1:6537 PRESTON RD
Practice Address - Street 2:
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75024-2610
Practice Address - Country:US
Practice Address - Phone:972-484-7700
Practice Address - Fax:972-484-7718
Is Sole Proprietor?:No
Enumeration Date:2011-05-04
Last Update Date:2016-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXQ9697207RI0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious Disease