Individual
NICHOLAS B CREEL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D. ,PA.
Contact information
Practice address
215 OAK DR S, STE A, LAKE JACKSON, TX 77566-5617
(979) 297-1241
(979) 297-5692
Mailing address
215 OAK DR S, STE A, LAKE JACKSON, TX 77566-5617
(979) 297-1241
(979) 297-5692
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
E1833
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
035580201
—
TX
Enumeration date
06/13/2005
Last updated
01/04/2012
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