Nicklebur, Scott A.
Nicklebur, Scott A. is an individual health care provider with primary practice located at 302 University Blvd , Round Rock TX 78665-1032. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Emergency Medical Services, Allopathic & Osteopathic Physicians / Internal Medicine. Allopathic & Osteopathic Physicians / Emergency Medical Services is his primary health care specialty. Nicklebur, Scott A. can be contacted via phone (512) 509-0200.Contact Information
Primary practice address
302 University Blvd
Round Rock TX 78665-1032
Phone: (512) 509-0200
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Emergency Medical Services | 207PE0004X | L3040 | Texas |
| Allopathic & Osteopathic Physicians / Internal Medicine | 207R00000X | L3040 | Texas |
Profile Details
| NPI number | 1740233600 |
|---|---|
| LBN Legal business name | Nicklebur, Scott A. |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | May 19th, 2006 |
| Last updated | Jan 7th, 2021 - about 5 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1740233600 | NPPES |
| Texas | MEDICAID | 170178102 | |
| Texas | MEDICAID | 170178101 |
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