Marietta, Nicole Rene

Marietta, Nicole Rene is an individual health care provider with primary practice located at 1651 Rock Prairie Rd Suite 102, College Station TX 77845-8652. She recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Family Medicine, Allopathic & Osteopathic Physicians / Obstetrics & Gynecology. Allopathic & Osteopathic Physicians / Family Medicine is her primary health care specialty. Marietta, Nicole Rene can be contacted via phone (979) 693-7400.

Contact Information

Primary practice address
1651 Rock Prairie Rd Suite 102 College Station TX 77845-8652
Phone: (979) 693-7400
Fax: (979) 693-7446
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X M2390 Texas
Allopathic & Osteopathic Physicians / Obstetrics & Gynecology 207V00000X M2390 Texas

Profile Details

NPI number 1639189632
LBN Legal business name Marietta, Nicole Rene
Credentials Doctor of Osteopathy (DO)
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 9th, 2006
Last updated Oct 17th, 2016 - about 8 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

Request for update

Identifiers

StateTypeNumberIssuer
All States NPI 1639189632 NPPES
Texas MEDICAID 189987501

Popular Providers