Provider Demographics
NPI:1821346453
Name:HERRING, NICHOLAS DALE
Entity Type:Individual
Prefix:MR
First Name:NICHOLAS
Middle Name:DALE
Last Name:HERRING
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 1:400 S HENDERSON ST
Mailing Address - Street 2:
Mailing Address - City:FORT WORTH
Mailing Address - State:TX
Mailing Address - Zip Code:76104-1017
Mailing Address - Country:US
Mailing Address - Phone:817-335-2583
Mailing Address - Fax:817-335-2597
Practice Address - Street 1:407 CANYON CREEK DR
Practice Address - Street 2:#108
Practice Address - City:TEMPLE
Practice Address - State:TX
Practice Address - Zip Code:76502-3291
Practice Address - Country:US
Practice Address - Phone:254-778-3736
Practice Address - Fax:254-771-2629
Is Sole Proprietor?:No
Enumeration Date:2012-08-29
Last Update Date:2012-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist