Organization
NICHOLAS B. CREEL, M.D., P.A.
Active
Other names
Nicholas B. Creel, M.D., P.A.
Organization subpart
No
Provider details
NPI number
Authorized official
KATHRYN ANN CREEL (OFFICE MANAGER)
(979) 297-1241
Entity
Organization
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
305R00000X
Preferred Provider Organization
Primary
E1833
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00R280
MEDICARE ID-TYPE UNSPECIFIED
TX
05
—
035580201
—
TX
Enumeration date
01/30/2012
Last updated
01/30/2012
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