Provider Demographics
NPI:1437421096
Name:NICHOLAS, TERRY M
Entity Type:Individual
Prefix:MR
First Name:TERRY
Middle Name:M
Last Name:NICHOLAS
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1111 CONCORD PL
Mailing Address - Street 2:
Mailing Address - City:MISSOURI CITY
Mailing Address - State:TX
Mailing Address - Zip Code:77459-6771
Mailing Address - Country:US
Mailing Address - Phone:832-545-0605
Mailing Address - Fax:
Practice Address - Street 1:1111 CONCORD PL
Practice Address - Street 2:
Practice Address - City:MISSOURI CITY
Practice Address - State:TX
Practice Address - Zip Code:77459-6771
Practice Address - Country:US
Practice Address - Phone:832-545-0605
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-01-29
Last Update Date:2023-05-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246ZS0410XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherSurgical Technologist