Individual
NICHOLAS JAMES NISSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
3001 BEE CAVE RD STE 220, AUSTIN, TX 78746-5590
(815) 354-8932
(617) 604-2403
Mailing address
5900 BALCONES DR STE 100, AUSTIN, TX 78731-4298
(815) 354-8932
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
U6038
TX
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
03/21/2020
Last updated
06/27/2024
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