Individual
MS. COLLEEN MCNICHOLAS-HENDRIX
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
400 SW 25TH AVE, MINERAL WELLS, TX 76067-8246
(940) 745-0484
(940) 328-6260
Mailing address
400 SW 25TH AVE, MINERAL WELLS, TX 76067-8246
(940) 745-0484
(940) 328-6260
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
251206
TX
363L00000X
Nurse Practitioner
Primary
AP105255
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
147183106
—
TX
Enumeration date
08/01/2006
Last updated
08/11/2020
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