Provider Demographics
NPI:1376631010
Name:TALARICO, NICK ANTHONY (DC)
Entity Type:Individual
Prefix:DR
First Name:NICK
Middle Name:ANTHONY
Last Name:TALARICO
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 1:5505 MONTANA AVE
Mailing Address - Street 2:SUITE B
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79903-4942
Mailing Address - Country:US
Mailing Address - Phone:915-772-8080
Mailing Address - Fax:915-772-0376
Practice Address - Street 1:5505 MONTANA AVE
Practice Address - Street 2:SUITE B
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79903-4942
Practice Address - Country:US
Practice Address - Phone:915-772-8080
Practice Address - Fax:915-772-0376
Is Sole Proprietor?:No
Enumeration Date:2006-10-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXDC7074111N00000X
NM1607111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor