Individual
DENISE NICKEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CPO
Contact information
Practice address
3030 MATLOCK RD STE 108, ARLINGTON, TX 76015-2934
(817) 467-9977
Mailing address
3030 MATLOCK RD STE 108, ARLINGTON, TX 76015-2934
(817) 467-9977
Taxonomy
Speciality
Code
Description
License number
State
222Z00000X
Orthotist
TX 1062
TX
224P00000X
Prosthetist
Primary
TX 1062
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
133334604
—
TX
Enumeration date
08/28/2009
Last updated
08/28/2009
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