Provider Demographics
NPI:1245323161
Name:NICASTRO, ERIC LEIGH (DC)
Entity type:Individual
Prefix:DR
First Name:ERIC
Middle Name:LEIGH
Last Name:NICASTRO
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:19802 RINGWALD CT
Mailing Address - Street 2:
Mailing Address - City:SPRING
Mailing Address - State:TX
Mailing Address - Zip Code:77379-5058
Mailing Address - Country:US
Mailing Address - Phone:281-876-2500
Mailing Address - Fax:281-876-2574
Practice Address - Street 1:367 GREENS RD
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77060-1903
Practice Address - Country:US
Practice Address - Phone:281-445-6944
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-02
Last Update Date:2022-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0104556445111N00000X
TX12981111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
U96243Medicare UPIN