Nickson, Dominique A
Nickson, Dominique A is an individual health care provider with primary practice located at 8876 Synergy Dr Suite 100, Mckinney TX 75070-1276. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Foot and Ankle Surgery, Allopathic & Osteopathic Physicians / Orthopaedic Surgery. Allopathic & Osteopathic Physicians / Orthopaedic Surgery is his primary health care specialty. Nickson, Dominique A can be contacted via phone (972) 547-0047.Contact Information
Primary practice address
8876 Synergy Dr Suite 100
Mckinney TX 75070-1276
Phone: (972) 547-0047
Fax: (877) 400-6329
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Foot and Ankle Surgery | 207XX0004X | L8866 | Texas |
| Allopathic & Osteopathic Physicians / Orthopaedic Surgery | 207X00000X | L8866 | Texas |
Profile Details
| NPI number | 1548211634 |
|---|---|
| LBN Legal business name | Nickson, Dominique A |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | May 13th, 2006 |
| Last updated | Jun 7th, 2024 - about last year |
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 | 1548211634 | NPPES |
| Texas | Other | 6512550001 | DME PTAN |
| Texas | Other | P01047820 | DME PTAN |
| Texas | Other | TXB128126 | DME PTAN |
| Texas | Other | L8866 | DME PTAN |
| Texas | Other | 2454999 | DME PTAN |
| Texas | Other | P00658084 | DME PTAN |
| Texas | MEDICAID | 285510801 | DME PTAN |
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