Provider Demographics
NPI:1538659487
Name:ST. CYR, NIKOLAS VAUGHN (MD)
Entity type:Individual
Prefix:MR
First Name:NIKOLAS
Middle Name:VAUGHN
Last Name:ST. CYR
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2012 W OHIO AVE
Mailing Address - Street 2:
Mailing Address - City:MIDLAND
Mailing Address - State:TX
Mailing Address - Zip Code:79701-5946
Mailing Address - Country:US
Mailing Address - Phone:432-221-4790
Mailing Address - Fax:432-221-4793
Practice Address - Street 1:2012 W OHIO AVE
Practice Address - Street 2:
Practice Address - City:MIDLAND
Practice Address - State:TX
Practice Address - Zip Code:79701-5946
Practice Address - Country:US
Practice Address - Phone:432-221-4790
Practice Address - Fax:432-221-4793
Is Sole Proprietor?:Yes
Enumeration Date:2018-05-16
Last Update Date:2024-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXU6087207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology