Individual
TODD PETER NIESKES
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LSA/CFA
Contact information
Practice address
201 S LAKELINE BLVD STE 405, CEDAR PARK, TX 78613-2735
(512) 381-4272
Mailing address
2028 WARWICK PL, NEW BRAUNFELS, TX 78130-3191
(927) 925-0981
Taxonomy
Speciality
Code
Description
License number
State
246ZC0007X
Surgical Assistant
Primary
117518
CO
Other
Enumeration date
11/30/2010
Last updated
11/30/2010
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