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Individual

MATTHEW NICKELL

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
2790 SW WILSHIRE BLVD, BURLESON, TX 76028-8338
(817) 484-2020
Mailing address
2790 SW WILSHIRE BLVD, BURLESON, TX 76028-8338
(817) 484-2020

Taxonomy

Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
1821593955
TX
207W00000X
Ophthalmology Physician
T4234
TX
390200000X
Student in an Organized Health Care Education/Training Program

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
BP10064044
PHYSICIAN IN TRAINING LICENSE
TX
Enumeration date
03/29/2018
Last updated
03/30/2026
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