Individual
JOHN NICOLAU
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1100 N MAIN AVE, SAN ANTONIO, TX 78212-4712
(210) 222-2154
(210) 227-6056
Mailing address
2191 NW MILITARY HWY, SAN ANTONIO, TX 78213-1836
(210) 348-8788
(210) 348-8768
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
M6803
TX
207WX0009X
Glaucoma Specialist (Ophthalmology) Physician
M6803
TX
207WX0108X
Uveitis and Ocular Inflammatory Disease (Ophthalmology) Physician
M6803
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1906315-06
—
TX
05
—
190631507
—
TX
Enumeration date
06/13/2007
Last updated
03/27/2019
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