Provider Demographics
NPI:1659601003
Name:ENGEL, NICK C (PT)
Entity Type:Individual
Prefix:
First Name:NICK
Middle Name:C
Last Name:ENGEL
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 2131
Mailing Address - Street 2:
Mailing Address - City:FREDERICKSBURG
Mailing Address - State:TX
Mailing Address - Zip Code:78624-1918
Mailing Address - Country:US
Mailing Address - Phone:830-997-2001
Mailing Address - Fax:830-997-0781
Practice Address - Street 1:1316 S STATE HIGHWAY 16
Practice Address - Street 2:
Practice Address - City:FREDERICKSBURG
Practice Address - State:TX
Practice Address - Zip Code:78624-5058
Practice Address - Country:US
Practice Address - Phone:830-997-2001
Practice Address - Fax:830-997-0781
Is Sole Proprietor?:No
Enumeration Date:2010-01-07
Last Update Date:2014-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX11941572251X0800X, 225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
No2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic