Provider Demographics
NPI:1427370261
Name:TAPIA, NICOLE MARIE (MD)
Entity Type:Individual
Prefix:
First Name:NICOLE
Middle Name:MARIE
Last Name:TAPIA
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 1:6550 FANNIN ST STE 1661
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77030-2765
Mailing Address - Country:US
Mailing Address - Phone:713-441-5141
Mailing Address - Fax:713-790-6472
Practice Address - Street 1:6550 FANNIN ST STE 1661
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77030-2765
Practice Address - Country:US
Practice Address - Phone:713-441-5141
Practice Address - Fax:713-790-6472
Is Sole Proprietor?:No
Enumeration Date:2010-02-21
Last Update Date:2021-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXP0308208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX368430001Medicaid
TX488960YKQHMedicare PIN