Individual
MARK EDWARD NICHOLS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
605 S CONROE MEDICAL DR, CONROE, TX 77304-4722
(936) 539-4004
(936) 539-3635
Mailing address
605 S CONROE MEDICAL DR, CONROE, TX 77304-4722
(936) 539-4004
(936) 539-3635
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
L0457
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1560377-03
—
TX
Enumeration date
09/12/2005
Last updated
03/07/2023
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