Provider Demographics
NPI:1982754461
Name:MIDDLETON, NICOLE A (DDS)
Entity Type:Individual
Prefix:
First Name:NICOLE
Middle Name:A
Last Name:MIDDLETON
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2150 W. 18TH STREET
Mailing Address - Street 2:SUITE 300
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77008
Mailing Address - Country:US
Mailing Address - Phone:713-526-0555
Mailing Address - Fax:713-526-1422
Practice Address - Street 1:1427 HAWTHORNE ST
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77006
Practice Address - Country:US
Practice Address - Phone:713-529-6071
Practice Address - Fax:713-526-1422
Is Sole Proprietor?:No
Enumeration Date:2007-01-10
Last Update Date:2018-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX208341223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice