Individual
HIRUT NICODIMOS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
302 UNIVERSITY BLVD, ROUND ROCK, TX 78665-1032
(512) 509-0200
Mailing address
302 UNIVERSITY BLVD, ROUND ROCK, TX 78665-1032
(512) 509-0200
Taxonomy
Speciality
Code
Description
License number
State
207XS0117X
Orthopaedic Surgery of the Spine Physician
PA06188
TX
363AM0700X
Medical Physician Assistant
Primary
PA06188
TX
363AS0400X
Surgical Physician Assistant
PA06188
TX
Other
Enumeration date
03/26/2009
Last updated
03/08/2013
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