# DONALD G NICHOLAS JR MD

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1770516817
- **Authorized official:** DR. DONALD GENE NICHOLAS JR. M.D. (OWNER)
- **Authorized official phone:** (972) 224-9090

## Contact information

- **Practice address:** 2701 PRINCE GEORGE AVE STE 100, DESOTO, TX 75115-2087
- **Practice address phone:** (972) 224-9090
- **Practice address fax:** (972) 224-9098
- **Mailing address:** 2701 PRINCE GEORGE AVE, SUITE 100, DESOTO, TX 75115-2087
- **Mailing address phone:** (972) 224-9090
- **Mailing address fax:** (972) 224-9098

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 208D00000X | General Practice Physician | H1995 | TX | Yes |

## Other

- **Enumeration date:** 07/09/2006
- **Last updated:** 10/06/2017