Individual
JEREMY NICHOLOPOULOS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
871 OLD ALICE RD, SUITE 600, BROWNSVILLE, TX 78520-8268
(956) 541-2102
(956) 541-2502
Mailing address
871 OLD ALICE RD, SUITE 600, BROWNSVILLE, TX 78520-8268
(956) 541-2102
(956) 541-2502
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
2090772
TX
225200000X
Physical Therapy Assistant
A5024
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2090772
STATE LICENSE
TX
Enumeration date
09/16/2015
Last updated
10/19/2018
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