Provider Demographics
NPI:1134367220
Name:NICOLAS M. NAMMOUR, M.D. P.A.
Entity type:Organization
Organization Name:NICOLAS M. NAMMOUR, M.D. P.A.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:NICOLAS
Authorized Official - Middle Name:MAHER
Authorized Official - Last Name:NAMMOUR
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:281-579-6800
Mailing Address - Street 1:18300 KATY FWY
Mailing Address - Street 2:SUITE 405
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77094-1114
Mailing Address - Country:US
Mailing Address - Phone:281-579-6800
Mailing Address - Fax:281-579-6804
Practice Address - Street 1:18300 KATY FWY
Practice Address - Street 2:SUITE 405
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77094-1114
Practice Address - Country:US
Practice Address - Phone:281-579-6800
Practice Address - Fax:281-579-6804
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-01-27
Last Update Date:2015-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXM58482084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX207027801Medicaid
TX207027801Medicaid
TX0A3518Medicare UPIN