Provider Demographics
NPI:1336369370
Name:BLOCK, NICOLLE GINSBERG (MD)
Entity Type:Individual
Prefix:
First Name:NICOLLE
Middle Name:GINSBERG
Last Name:BLOCK
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:5220 W UNIVERSITY DR STE 100
Mailing Address - Street 2:
Mailing Address - City:MCKINNEY
Mailing Address - State:TX
Mailing Address - Zip Code:75071-7402
Mailing Address - Country:US
Mailing Address - Phone:469-800-5100
Mailing Address - Fax:469-800-5110
Practice Address - Street 1:5220 W UNIVERSITY DR STE 100
Practice Address - Street 2:
Practice Address - City:MCKINNEY
Practice Address - State:TX
Practice Address - Zip Code:75071-7402
Practice Address - Country:US
Practice Address - Phone:469-800-5100
Practice Address - Fax:469-800-5110
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-01
Last Update Date:2022-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXN8168207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine