Provider Demographics
NPI:1245837772
Name:FILLION-ROBIN, NICOLE (LAC, MACOM, DIPL OM)
Entity type:Individual
Prefix:
First Name:NICOLE
Middle Name:
Last Name:FILLION-ROBIN
Suffix:
Gender:F
Credentials:LAC, MACOM, DIPL OM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11307 BURTON ST
Mailing Address - Street 2:
Mailing Address - City:MANOR
Mailing Address - State:TX
Mailing Address - Zip Code:78653-5363
Mailing Address - Country:US
Mailing Address - Phone:214-549-5880
Mailing Address - Fax:
Practice Address - Street 1:5609 ADAMS AVE STE B
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78756-1133
Practice Address - Country:US
Practice Address - Phone:512-270-1664
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-10-07
Last Update Date:2020-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAC01980171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist