Provider Demographics
NPI:1669765137
Name:NEXUS PHYSICIANS SERVICES PLLC
Entity type:Organization
Organization Name:NEXUS PHYSICIANS SERVICES PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRACTICE ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:DEUNIQUE
Authorized Official - Middle Name:
Authorized Official - Last Name:WILSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:616-325-7879
Mailing Address - Street 1:PO BOX 66
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77001-0066
Mailing Address - Country:US
Mailing Address - Phone:713-589-4122
Mailing Address - Fax:713-583-5185
Practice Address - Street 1:2929 WOODLAND PARK DR
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77082-2687
Practice Address - Country:US
Practice Address - Phone:281-293-7774
Practice Address - Fax:713-355-6822
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-05-17
Last Update Date:2025-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedicalGroup - Multi-Specialty
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX310178401Medicaid
TX310178402Medicaid