Provider Demographics
NPI:1891135836
Name:NICHOLS, LORENZO II (OD)
Entity Type:Individual
Prefix:DR
First Name:LORENZO
Middle Name:
Last Name:NICHOLS
Suffix:II
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2310 SW MILITARY DR STE 248B
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78224-1409
Mailing Address - Country:US
Mailing Address - Phone:210-932-9754
Mailing Address - Fax:210-932-0495
Practice Address - Street 1:2310 SW MILITARY DR STE 248B
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78224-1409
Practice Address - Country:US
Practice Address - Phone:210-932-9754
Practice Address - Fax:210-932-0495
Is Sole Proprietor?:No
Enumeration Date:2013-07-03
Last Update Date:2021-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV763152W00000X
TX8521T152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist