Individual
SHAWNN D NICHOLS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
7400 MERTON MINTER BLVD, MEDICAL STAFF OFFICE (11M), SAN ANTONIO, TX 78229-4404
(210) 616-8385
(210) 443-0322
Mailing address
3551 ROGER BROOKE DR, FORT SAM HOUSTON, TX 78234-4504
(210) 916-3334
(210) 916-2202
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
36084412
OH
2086X0206X
Surgical Oncology Physician
Primary
35.084414
OH
Other
Enumeration date
10/22/2005
Last updated
09/26/2024
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