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Individual

DR. DONALD GENE NICHOLAS JR.

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
1013 HICKORY BEND DR, DESOTO, TX 75115-3846
(972) 224-9090
Mailing address
PO BOX 2619, DESOTO, TX 75123-2619
(214) 734-5380
(972) 224-9098

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
H1995
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
H1995
PHYSICIAN PERMIT
TX
Enumeration date
09/27/2005
Last updated
03/20/2024
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