Individual
NICHOLAS TRAVIS FERGUSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
301 UNIVERSITY BLVD, GALVESTON, TX 77555-5313
(409) 772-7150
Mailing address
PO BOX 31309, LOS ANGELES, CA 90031-0309
(323) 442-8541
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
MT211608
PA
2085R0202X
Diagnostic Radiology Physician
A154617
CA
2085R0202X
Diagnostic Radiology Physician
Primary
T4918
TX
Other
Enumeration date
06/13/2016
Last updated
03/16/2023
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