Individual
DR. ADIL NOSHIR NICOLWALA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1103 WOODSON DR, CALDWELL, TX 77836-1052
(979) 567-7080
(979) 731-1695
Mailing address
1500 UNIVERSITY DR E, SUITE 100, COLLEGE STATION, TX 77840-2600
(979) 846-1100
(979) 260-9390
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
L0879
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1544678-01
BCSCHC FQHC SITE MEDICAID NUMBER
TX
01
—
1649265646
FQHC SITE NPI/BCSCHC
TX
01
—
1821185299
AGENCY NPI
TX
05
—
43972102
—
TX
01
—
80565Y
BLUE CROSS
TX
Enumeration date
04/03/2006
Last updated
09/12/2024
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