Provider Demographics
NPI:1497085484
Name:SPLENSER, NICOLE CHANTAL (PA-C)
Entity Type:Individual
Prefix:MRS
First Name:NICOLE
Middle Name:CHANTAL
Last Name:SPLENSER
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:MISS
Other - First Name:NICOLE
Other - Middle Name:CHANTAL
Other - Last Name:O'NEAL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA-C
Mailing Address - Street 1:5711 ALMEDA RD
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77004-7303
Mailing Address - Country:US
Mailing Address - Phone:713-520-8385
Mailing Address - Fax:713-520-5029
Practice Address - Street 1:5711 ALMEDA RD
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77004-7303
Practice Address - Country:US
Practice Address - Phone:713-520-8385
Practice Address - Fax:713-520-5029
Is Sole Proprietor?:No
Enumeration Date:2010-01-13
Last Update Date:2010-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXPA06125363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXPA06125OtherPHYSICIAN ASSISTANT PERMIT