Provider Demographics
NPI:1407593882
Name:CREEL, NADINE (LMT)
Entity Type:Individual
Prefix:
First Name:NADINE
Middle Name:
Last Name:CREEL
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:NADINE
Other - Middle Name:
Other - Last Name:RAMON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LMT
Mailing Address - Street 1:350 E VISTA RIDGE MALL DR APT 614
Mailing Address - Street 2:
Mailing Address - City:LEWISVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:75067-4080
Mailing Address - Country:US
Mailing Address - Phone:214-536-1010
Mailing Address - Fax:
Practice Address - Street 1:7211 PRESTON RD # T3920
Practice Address - Street 2:
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75024-4700
Practice Address - Country:US
Practice Address - Phone:214-867-1200
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-05-17
Last Update Date:2022-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX110784225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist