Individual
NOEL NANI NICK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PSYD
Contact information
Practice address
101 N SHORELINE BLVD, SUITE 301, CORPUS CHRISTI, TX 78401-2824
(361) 883-9110
(361) 887-1080
Mailing address
PO BOX 348, CORPUS CHRISTI, TX 78403-0348
(361) 883-9110
(361) 887-1080
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
34031
TX
103TC0700X
Clinical Psychologist
779
HI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
8F9763
MEDICARE INDIVIDUAL TPAN
TX
Enumeration date
09/29/2006
Last updated
05/15/2009
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