Individual
PATRICIA BAILEY NICOL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
6101 E OLTORF ST # TX78741, AUSTIN, TX 78741-7500
(512) 623-9316
Mailing address
19545 SANDCASTLE DR, SPICEWOOD, TX 78669-6702
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
H6905
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
NONE
NONE
—
Enumeration date
07/07/2020
Last updated
07/07/2020
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